Two challenging surgical cases of cochlear implantation under local anesthesia

Cochlear implants are considered a first-choice treatment for auditory rehabilitation of patients with sensory deafness. This treatment is not only able to restore patients’ hearing ability, but also to improve social interactions. reimplantation may be needed under certain circumstances, such as device failure or medical complications. this kind of surgery is usually carried out under general anesthesia. Our goal was to describe how even challenging cases of cochlear implantation or reimplantation could be successfully carried out under local anesthesia. two elderly patients in poor general health conditions were subjected to cochlear implantation under local anesthesia and sedation. Case one is about a woman subjected to a cochlear implant substitution with an intra-operative rupture of the array inside the cochlea; case two describes cochlear implantation in a man presenting incipient dementia and basal turn ossification due to otosclerosis. Hearing results were satisfying in both cases. Postoperative recovery was quick and devoid of complications. in our experience cochlear implantation in local anesthesia represents a good treatment option, especially when general anesthesia can be too risky due to patients’ comorbidities.