Retrospective complication rate comparison between surgical techniques in paediatric cochlear implantation

Abstract

In our institution, cochlear implantation in young patients through the SupraMeatal Approach resulted in significantly more (infectious) complications than those operated through the Mastoidectomy with Posterior Tympanotomy Approach. Outcomes from our institution recommends using the Mastoidectomy with Posterior Tympanotomy Approach when opting for a cochlear implant surgical technique in young children who are more prone to develop infectious complications.

Endoscope-Assisted Cochlear Implantation

“…It is easier to identify the RW with a transcanal approach, but transcanal insertion vector may carry the risk of leading to a more lateral position of the array in the ST and may increase the battery energy needed to stimulate the spiral ganglion neurons. Also, elevating the tympanic annulus carries a significant risk of injury to the annulus or tympanic membrane [ 20 , 31 , 32 ]. We think that transfacial recess endoscopic identification of the RW obviates the need to switch to a transcanal approach.…”

“…EES can be applied not only during the conventional approach, but also while using other alternative CI techniques ( Table 1 ), which can be grouped as transmeatal (suprameatal and endomeatal) and endoscope-assisted (percutaneous, transcanal and transfacial recess) approaches ( Table 4 ) [ 15 , 19 , 20 , 31 , 34 - 37 ]. The disadvantages of alternative techniques are electrode exposure or extrusion and cholesteatoma formation; ear canal or tympanic membrane injuries were reported to occur in almost half of the patients [ 20 , 32 ]. Endoscope-assisted approaches may necessitate individually customized drill guides in addition to the availability of image guided surgical technology [ 35 , 36 ].…”

Magnet dislocation during 3 T magnetic resonance imaging in a pediatric case with cochlear implant

“… 4 Generally, solutions to these problems have been approached through modifications in the surgical technique. 5 One of the problems more often seen, and one which cannot be solved by surgical modification, is that experienced in MRI procedures. An MRI is an imaging technique that is widely used for the diagnosis of many diseases such as stroke, neurodegenerative diseases and tumors.…”

Endoscopic‐Assisted Cochlear Implantation in Children with Malformed Ears

“…The first advantage offered by the endoscopic-assisted technique is magnification—specifically, the enlargement of the visual field as the endoscope approaches the object of interest. The second is the unique ability of angled endoscopes to visualize “around the corner.” Both features contribute to obtaining a panoramic view of the anatomic structures, which may not be possible with the direct line of vision of the microscope; this possibility is particularly important for accessibility to the RW area and for proper insertion of the electrodes into the ST. 25,26 Since some electrodes are particularly flexible and elastic whereas others may require removal of the stylet with one hand and insertion with the other, it is an unnecessary challenge to try to insert the electrode while one hand is holding the endoscope. Therefore, we do not recommend routinely inserting the electrode under endoscopic view.…”