Combined Endoscopic/Microscopic Cochlear Implantation Through the Oval Window

Abstract

Standard round window (RW) cochlear implantation is a well-described technique. Implantation might be difficult in patients with inner and middle ear anomalies, in some cases because of not achieving adequate exposure to the RW, with a related higher risk of complications such as facial nerve injury. It is proposed a combined microscopic/endoscopic oval window approach in a 63 year old man affected by bilateral Menière disease, with bilateral severe sensorineural hearing loss, speech discrimination score for bysillabic words under 40% and a hidden RW by anomalous facial nerve course. All electrodes entered the cochlear with good freefield thresholds and auditory ability results. A partial marginalis nerve palsy occurred at the second postoperative day and completely reversed at 2 months from surgery. Endoscopicassisted oval window cochlear implantation may be a safe alternative surgical technique in cases where surgeons are not able to access RW.

Endoscope-Assisted Cochlear Implantation in Atretic Round Window

“…Several alternative surgical approaches for CI surgery have been suggested to handle challenging cases effectively. These approaches involve standalone microscopic methods, and more recently, a fusion of endoscopic and microscopic or solely endoscopic techniques has been introduced to assess the RW [ 4 ].…”