Cochlear Implantation in Common Cavity Malformations Using a Transmastoid Labyrinthotomy Approach

McElveen, John T.; Carrasco, Vincent N.; Miyamoto, Richard T.; Linthicum, Fred H.

doi:10.1097/00005537-199708000-00005

Cited by 88 publications

(69 citation statements)

References 10 publications

(10 reference statements)

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“…However, in an instance where the imaging studies show symmetric malformations, ASSR may be the only way to determine the functional aspect of a cochlear nerve. The surgical aspects of cochlear implantation in common cavity malformations have been previously reported in the literature [2,5,6,8,11,12,[16][17][18]. The surgical technique of a double labyrinthotomy was chosen for our patients as it is perfectly suited for the placement of the new specialized electrode.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopically guided placement of prefabricated cochlear implant electrodes in a common cavity malformation

Manolidis

Tonini

Spitzer

2006

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 99%

“…For both patients, a double posterior labyrinthotomy technique was used to place the electrode in the right common cavity as has been previously described [11]. A third labyrinthotomy with a drill bit appropriate for a thin endoscope (2 mm diameter) was placed above the first two labyrinthotomies.…”

Section: Casementioning

confidence: 99%

Endoscopically guided placement of prefabricated cochlear implant electrodes in a common cavity malformation

Manolidis

Tonini

Spitzer

2006

International Journal of Pediatric Otorhinolaryngology

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“…According to the surgeons who support this view, although others suggest the contrary, the direct approach to the common cavity is more effective for the electrode array placement, minimizes risk to the facial nerve and may decrease the likelihood of postoperative CSF leaks (McElveen et al, 1997). In the implanted common cavity case reported by Tucci et al (1995), a canal wall-down mastoidectomy was performed and the external meatus was closed.…”

Section: Common Cavity Deformitymentioning

confidence: 99%

Cochlear implant surgery in challenging cases

Nikolopoulos¹,

Kiprouli²

2004

Cochlear Implants Int.

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Expanding selection criteria and increasing numbers of cochlear implantations have revealed several challenging cases with regard to surgery and medical point of view. Cochlear implantation of congenitally deaf children with inner-ear malformations may involve difficulties in preoperative evaluation, surgical approach and postoperative follow-up. Cochlear nerve aplasia (as evidence of only one existing nerve in three dimensional magnetic resonance imaging) and hypoplastic cochleas are among the most difficult cases and sometimes children are considered unsuitable for cochlear implantation. However, there is always the possibility that hypoplastic cochleas may include ganglion cells and the only nerve in the internal auditory canal (facial nerve) may contain auditory fibres as well. A positive history of auditory experience and evidence of electrical auditory brainstem response or response to the promontory or round window electrical stimulation may imply that a functioning auditory system is in place. Malformations like common cavity deformity, isolated bilateral vestibular aqueduct enlargement and Mondini dysplasia are usually less challenging, although cerebrospinal fluid leak and postoperative meningitis may be a possibility. In cases of post-meningitic deaf patients, ossification (or obliteration) may be a serious problem even if computed tomography and MRI scan show a patent cochlea or minimal changes. Acoustic neuromas and neurofibromatosis type 2 are other challenging cases, as there is always the possibility that the sensorineural hearing loss is secondary to cochlear damage by interference of the tumour to cochlear blood supply. In conclusion, challenging cases are becoming more common as we are expanding selection criteria, and we should be prepared for alternative cochlear implant devices (straight electrode arrays, dual arrays, compressed arrays, etc.), increased rate of possible complications at, and following, surgery, and functional outcome that may vary considerably among implantees.

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“…McElveen et al described a transmastoid labyrinthotomy approach to common cavity malformations to minimise the injury risk for an aberrant facial nerve. 21 Limitations of the present study were that the patient series was small and aberrant extension of the facial nerve was not confirmed by surgery. Despite the small series, sufficient patients were included to allow the detection of inner-ear abnormalities.…”

Section: Figmentioning

confidence: 80%

Facial nerve anomalies in paediatric cochlear implant candidates: radiological evaluation

2016

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Background: Pre-operative radiological identification of facial nerve anomalies can help prevent intra-operative facial nerve injury during cochlear implantation. This study aimed to evaluate the incidence and configuration of facial nerve anomalies and their concurrence with inner-ear anomalies in cochlear implant candidates.Methods: Inner-ear and concomitant facial nerve anomalies were evaluated by magnetic resonance imaging and temporal high-resolution computed tomography in 48 children with congenital sensorineural hearing loss who were cochlear implant candidates.Results: Inner-ear anomalies were present in 11 out of 48 patients (23 per cent) and concomitant facial nerve anomalies were present on 7 sides in 4 patients (7 per cent of the total). Facial nerve anomalies were accompanied by cochlear or vestibular malformation.Conclusion: Potential facial nerve abnormalities should always be considered in patients with inner-ear anomalies. Pre-operative facial nerve imaging can increase the surgeon's confidence to plan and perform cochlear implantation. Magnetic resonance imaging should be used to detect inner-ear anomalies; if these are identified, temporal high-resolution computed tomography should be used to evaluate the facial nerve.

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Cochlear Implantation in Common Cavity Malformations Using a Transmastoid Labyrinthotomy Approach

Cited by 88 publications

References 10 publications

Endoscopically guided placement of prefabricated cochlear implant electrodes in a common cavity malformation

Endoscopically guided placement of prefabricated cochlear implant electrodes in a common cavity malformation

Cochlear implant surgery in challenging cases

Facial nerve anomalies in paediatric cochlear implant candidates: radiological evaluation

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