engleski

Retromeatal approach for cochlear implantation

Last three decades surgical approach for cochlear implantation is similar or almost unchanged.From November 1st 2000, our technique was performed in 52 patients.First steps are the same as in the retroauricular approach in the middle ear surgery (retroauricular incision is performed, as a part of classical J-shaped skin incision and posterior tympanomeatal flap is elevated). Bone curettage is performed in the same place as for stapedectomy in order to visualise stapes and promontory antero-inferior to stapes. After that an opening like antrotomy is performed throw which we show the area of antrum and nervus facialis. In addition, we made an opening by diamond drill 4-5 mm laterally and above the knee of nervus facialis from mastoid toward external ear canal, or toward the place of previous ear canal curettage. Cochleostomy is drilled in the classical place, antero-inferior to the stapes. Rest of J-shaped incision is than performed and receiver-stimulator bed and electrode array channel is drilled. The receiver-stimulator is fixed in the bed. The electrode is placed in the mastoid and through the opening between mastoid and ear canal and after that through the groove in external canal and passed into the cochleostomy. A small part of temporal fascia is used to cover the groove. X-rays confirmed that in all patients the electrode was in the right place. There was no facial nerve injury nor other complications. Our technique is faster than classical approach and also it is much safer.

cochlear implantation; retromeatal approach

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