Author/Editor		Branica, Srečko; Šprem, Nikola; Dawidowsky, Krsto; Kovač, Lana
Title		Retromeatal approach for cochlear implantation
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 43, št. Suppl 3
Publication year		2004
Volume		str. 43-5
Language		eng
Abstract		For the past three decades, the surgical approach for cochlear implantation has remained almost unchanged. Since November 1, 2000, a new modified technique we have developed has been used in 52 patients. The first few steps are the same as in the retroauricular approach in middle ear surgery (a retroauricular incision is performed as part of the standard J-shaped skin incision, and then a posterior tympanomeatal flap is lifted). Bone curettage is performed in the same place as for stapedectomy in order to visualise the stapes and promontory antero-inferiorly to the stapes. An opening such as antrotomy is then made, through which the area of the antrum and nervus facialis is exposed. In addition, another opening is made using a diamond drill, 4-5 mm laterally and above the facial nerve bend from the mastoid towards the external ear canal, or towards the site of previous ear canal curettage. Cochleostomy is drilled in the usual place, antero-inferiorly to the stapes. The remaining portion of the J-shaped incision is then performed and the receiver-stimulator bed and electrode array channel are drilled. The receiver-stimulator is fixed into the bed. The electrode is placed in the mastoid and through the opening between the mastoid and the ear canal, and then through the groove in the external canal, and passed into the cochleostomy. A small part of the temporal fascia is used to cover the groove. X-rays have confirmed that the electrode was in the right place in all patients. There was no facial nerve injury or any other complications. Our technique is quicker than the standard approach and also much safer.
Descriptors		COCHLEAR IMPLANT TREATMENT OUTCOME