gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V. (DGHNOKHC)

ISSN 1865-1038

Economic approach to the middle ear for cochlear implantation

Poster Cochlear Implant

Suche in Medline nach

  • corresponding author Ivan Zenev - Medical University Sofia, Sofia, Bulgaria
  • Emil Zenev - PAN-Klinik, Köln

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2007;3:Doc01

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/journals/cpo/2007-3/cpo000266.shtml

Veröffentlicht: 25. April 2007

© 2007 Zenev et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Abstract

In 50 patients aged among 18 months to 11 years we used short retroauricular skin incision with formation of two skin flaps and one muscular-perosteum flap. Together with the anterior flap we also rise periosteum thus revealing the suprameatal spina, with ongoing detachment of skin from the posterior canal wall until the fibrous anulus is being reached. We put posterior wall canal skin ventraly with specially designed by us wound stretchener. Using House curette we remove part of the bone that is situated between exiting point of chorda and Rivini’s notch. This allows us to inspect incudostapedial joint and promontory. We form bony tunnel immediately behind the suprameatal spina. Direction of this tunnel points towards the incudostapedial joint and penetration of tympanic cavity is just above it. Using metal template and diamond burr we cut away bed for ceramic capsule of the implant and drill opening for the electrode.

We perform cochleostomy trough the external acoustic meatus between bony wall and elevated skin with diamond burr. The cochleostomy lies immediately over round window and heads up in oblique ventral direction. We carry out electrode insertion after securing the ceramic capsule to the bony bed. Electrode runs trough bony canal, middle ear and cochleostomy to the cochlear duct. After telemetric measurements and adjustments we close wound by suturing and tight dressing for the next 3 or 4 days.

This method offers the less invasive approach, short operation time and lack of risk to the adjacent structures as facial nerve or blood supply of the skin flaps and so on.