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Cochlear Implantation Via the Middle Fossa Approach: Surgical and Programming Considerations.
MedLine Citation:
PMID:  23150094     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To report the results of cochlear implantation via the middle fossa approach in 4 patients, discuss the complications, and present a detailed description of the programming specifications in these cases. STUDY DESIGN: Retrospective case review. SETTING: Tertiary-care referral center with a well-established cochlear implant program. PATIENTS: Four patients with bilateral canal wall down mastoid cavities who underwent the middle fossa approach for cochlear implantation. INTERVENTIONS: Cochlear implantation and subsequent rehabilitation. A middle fossa approach with cochleostomy was successfully performed on the most superficial part of the apical turn in 4 patients. A Nucleus 24 cochlear implant system was used in 3 patients and a MED-EL Sonata Medium device in 1 patient. The single electrode array was inserted through a cochleostomy from the cochlear apex and occupied the apical, middle, and basal turns. Telemetry and intraoperative impedance recordings were performed at the end of surgery. A CT scan of the temporal bones was performed to document electrode insertion for all of the patients. MAIN OUTCOME MEASURES: Complications, hearing thresholds, and speech perception outcomes were evaluated. RESULTS: Neural response telemetry showed present responses in all but 1 patient, who demonstrated facial nerve stimulation during the test. Open-set speech perception varied from 30% to 100%, despite the frequency allocation order of the MAP. CONCLUSION: Cochlear implantation via the middle cranial fossa is a safe approach, although it is a challenging procedure, even for experienced surgeons.
Authors:
Ricardo Ferreira Bento; Aline Gomes Bittencourt; Maria Valéria Schmidt Goffi-Gomez; Paola Samuel; Robinson Koji Tsuji; Rubens de Brito
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  33     ISSN:  1537-4505     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1516-1524     Citation Subset:  -    
Affiliation:
Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
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