gms | German Medical Science

Objective: Small incision cochlear implant surgery in children has been advocated to reduce post-operative morbidity and have a psychological effect on parents. With small incision techniques, it is not always possible to securely fix the device in place. This risks displacement of the device, particularly in active children. This technique has been used through minimal-access approach in children.

Methods: Among 80 cochlear implantations in children performed between January 2003 and December 2010, there were 32 cases with very thin cortical bone in which small incision cochlear implant surgery were performed. As drill – hole fixation methods can carry the potential for dural injury we have used the suture fixation through the cranial periosteum. This method shortened the surgical time and there were no specific postoperative complications.

Results: One complication has occurred related to the current technique (maximum follow up 30 months). No flap necrosis, hematoma or infection, nor extrusion or breakdown was encountered with either technique. Revision surgery was performed in 2 patients (1 with small incision due to posttraumatic device failure) and one due to cholesteatoma. The use of this minimally invasive surgical technique did not increase the surgical risk.

Conclusion: Cochlear implantation can be performed using small incisions with periosteal sutures of the receiver. The described approach therefore appears to be a safe and time-effective alternative to the standard procedure in cochlear implant surgery.