Cochlear implantation trough the middle cranial fossa: a novel approach to access the basal turn of the cochlea

Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Tempestini, João Paulo Ratto; Jácomo, Alfredo Luiz; Bento, Ricardo Ferreira; Brito, Rubens de

doi:10.5935/1808-8694.20130028

Cited by 6 publications

(2 citation statements)

References 32 publications

(50 reference statements)

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“…This procedure is challenging, even in experienced hands. Facial nerve and cerebrovascular injuries are possible complications of this procedure [13] . Subtotal petrosectomy and middle cavity obliteration is another alternative technique for cochlear implantation.…”

Section: Discussionmentioning

confidence: 99%

Alternative Techniques in Cochlear Implantation

Sürmelioğlu¹,

Özdemir²,

Tarkan³

et al. 2016

Int Adv Otol

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OBJECTIVE:To review the alternative techniques in cochlear implantation and to compare the complications with different techniques. MATERIALS and METHODS:Patients who had undergone cochlear implantation were reviewed. Those patients who were operated using alternative techniques were selected and evaluated for the cause of their hearing loss and for the type of alternative technique that was utilized. Complication types and rates in these patients were evaluated. RESULTS:In total, 38 patients were operated using alternative techniques following preoperative or intraoperative findings. The mean age of the patients was 8.3 (1-51) years. There were 20 male and 18 female patients. Thirteen patients were operated with a suprameatal approach and 18 with a transcanal approach. Resection of the bony part of the external ear canal and reconstruction (canal wall down technique) was performed in seven patients. Postoperative complications included wound infection, hematoma, chorda tympani injury, and tympanic membrane perforation. CONCLUSION:Cochlear implantation is an effective method in the rehabilitation of sensorineural hearing loss. Complications are rare but can sometimes cause hematoma, taste impairment, tympanic membrane perforation, or wound infections. The standard procedure is not always suitable for patients with temporal bone abnormalities. Surgeons performing cochlear implantation should be aware of these variations and should be able to perform alternative implant techniques in these cases.

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Section: Discussionmentioning

confidence: 99%

Alternative Techniques in Cochlear Implantation

Sürmelioğlu¹,

Özdemir²,

Tarkan³

et al. 2016

Int Adv Otol

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show abstract

“…Rubens de Brito et al,7 8 in 2013, published a study of 50 temporal bones with the objective of describing a novel approach for exposing the basal turn of the cochlea through the middle fossa for cochlear implantation. They used the superior petrosal sinus, the skeletonized petrous apex, the lateral surface of the meatal plane trailed in its most proximal portion, and the GSPN as landmarks to perform a cochleostomy in the basal turn of the cochlea and cochlear implantation in direction of the apex (oriented toward the arcuate eminence direction).…”

Section: Review Of the Literaturementioning

confidence: 99%

Cochlear Implantation through the Middle Fossa Approach: A Review of Related Temporal Bone Studies and Reported Cases

Lesser

Neto

Martins

et al. 2016

Int Arch Otorhinolaryngol

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Introduction Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. Objective The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. Conclusions The middle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated.

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Decompression of the tympanic and labyrinthine segments of the facial nerve by middle cranial fossa approach: an anatomic study

et al. 2016

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Cochlear implantation trough the middle cranial fossa: a novel approach to access the basal turn of the cochlea

Abstract: The proposed approach is simple to use and provides sufficient exposure of the basal turn of the cochlea.

Cited by 6 publications

References 32 publications

Alternative Techniques in Cochlear Implantation

Alternative Techniques in Cochlear Implantation

Cochlear Implantation through the Middle Fossa Approach: A Review of Related Temporal Bone Studies and Reported Cases

Decompression of the tympanic and labyrinthine segments of the facial nerve by middle cranial fossa approach: an anatomic study

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