Common cavity and custom-made electrodes: Speech perception and audiological performance of children with common cavity implanted with a custom-made MED-EL electrode

Cochlear implantation in 21 patients with common cavity malformation

“…Papsin considered that the distinction between CC and cochlear hypoplasia was that the latter displayed differentiation into cochlear and vestibular elements, and a cochlea that was smaller than normal. As regards surgical technique, three approaches for CI are reported in CC deformity: the facial recess approach, canal wall-down mastoidectomy approach, and transmastoid labyrinthotomy approach [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The facial recess approach is the standard technique for CI, but the risk of facial paralysis increases in patients with CC because the facial nerve may follow an aberrant course.…”

“…To improve the surgical technique and reduce the operative time, Beltrame postbox-like slit in the same position as the double posterior labyrinthotomy. They considered this technique quicker and easier to perform than the double posterior labyrinthotomy, but that it might result in more CSF gushers and increased potential for meningitis [5]. We have used a single-slit labyrinthotomy technique, similar to the single-slit cochleostomy reported by Beltrame et al, in patients with CC over the last decade, and have found that the single-slit labyrinthotomy was large enough to implant the preshaped electrode array and to deal with CSF gushers.…”

“…We found similar ambiguities when we examined the literature on cochlear implantation (CI) in patients with CC. CI in the ear with CC was first reported by Jackler et al in 1987 [4], and currently it is widely accepted that CI is a safe and effective treatment for children with CC [5]. However, cerebrospinal fluid (CSF) gusher, anomalous course of the facial nerve, and penetration of the electrode array into the internal auditory canal (IAC) remain major challenges for surgeons.…”

“…However, cerebrospinal fluid (CSF) gusher, anomalous course of the facial nerve, and penetration of the electrode array into the internal auditory canal (IAC) remain major challenges for surgeons. Three surgical approaches for CI are used in CC deformity: the facial recess approach, canal walldown mastoidectomy approach, and transmastoid labyrinthotomy approach [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

“…Although previous studies have reported that most patients with CC benefit from CI, outcomes varied greatly among individuals, from detection of environmental sounds to excellent performance similar to that of patients with normal cochleas [4][5][6][7][8][9][11][12][13][14][15][16]19]. In addition, few studies have focused on the long-term postoperative audiological and speech development of patients with CC.…”