Table of Contents
Advances in Otolaryngology
Volume 2014, Article ID 509703, 5 pages
http://dx.doi.org/10.1155/2014/509703
Clinical Study

The Modified Transcanal Approach for Cochlear Implantation: Technique and Results

1Departments of Otorhinolaryngology, Ain-Shams University, Cairo, Egypt
2Faculty of Medicine, Ain-Shams University, 34 a El Higaz Street, Heliopolis, Cairo 11351, Egypt
3El Sahel Teaching Hospital, Cairo, Egypt

Received 29 July 2014; Accepted 24 October 2014; Published 13 November 2014

Academic Editor: Tino Just

Copyright © 2014 Badr Eldin Mostafa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this work is to present a modified transcanal technique for cochlear implantation. It was a prospective study on 125 cochlear implant patients presenting to two tertiary referral hospitals between January 2010 and January 2013 and followed up for 6–30 months. Their age range was 2–56 (mean 3.4 years) and the male: female ratio was of 2.1 : 1. A modified transcanal technique was adopted through a small postauricular incision. A tympanomeatal flap is elevated, the middle ear is exposed, and the round window membrane is exposed by drilling the overhanging niche. The electrode is channeled in an open trough along the posterosuperior meatal wall, which is reconstructed by autologous cartilage. The round window was used for insertion in 110 patients and a cochleostomy in 15. The main outcome measures were technical steps, operative time, and ease and completeness of electrode insertion. The actual surgical time (excluding device testing) ranged between 25 and 40 minutes (mean 30.1 min). There were 115 complete insertions and 10 partials. There were 6 chorda tympani injuries, 2 electrode exposures with 1 requiring revision, and 2 cases with a tympanic membrane perforation which were grafted uneventfully. One case had severe infection with extrusion of the device 1 year after successful implantation.