| Cochlear implant soft surgery: fact or fantasy? | |
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MedLine Citation:
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PMID: 9334767 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A basic surgical principle is to be as gentle as possible to accomplish the goals of the operation. The concept of "soft surgery" for cochlear implants consisted of a small, localized cochleostomy and gentle electrode insertion, the hope being that by limiting damage to the inner ear, superior hearing results might be obtained. The technique includes deferring the cochleostomy until immediately before electrode insertion, use of a large burr to flatten the promontory, followed by a smaller burr to expose the endosteum, preservation of the endosteum of the scala tympani, smoothing of the bony edges with burrs and dissectors, limited opening of the scala tympani, no suctioning of perilymph, gentle electrode insertion, and potential use of a lubricant to facilitate insertion. Although this technique has a theoretic basis, is esthetically satisfying, and has been used in many cases involving the Nucleus device at multiple centers, no data are available that demonstrate its advantages. Furthermore, the Clarion device, the results of which seem to be comparable to those of the Nucleus device, requires much more extensive and potentially damaging surgery. The pros and cons of soft surgery will be discussed. Although soft surgery seems desirable to limit trauma within the cochlea, other factors such as full electrode insertion, stimulation strategy, and survival of ganglion cells may be more important predictors of successful results. |
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Authors:
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N L Cohen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Volume: 117 ISSN: 0194-5998 ISO Abbreviation: Otolaryngol Head Neck Surg Publication Date: 1997 Sep |
Date Detail:
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Created Date: 1997-11-13 Completed Date: 1997-11-13 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8508176 Medline TA: Otolaryngol Head Neck Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 214-6 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology, New York University School of Medicine, NY 10016, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cell Survival Cochlea / injuries, surgery* Cochlear Implantation / instrumentation, methods* Cochlear Implants Ear, Inner / surgery Electric Stimulation Forecasting Hearing / physiology Humans Hyaluronic Acid / administration & dosage, therapeutic use Intraoperative Complications / prevention & control Lubrication Multicenter Studies as Topic Osteotomy / instrumentation Perilymph / physiology Prosthesis Design Scala Tympani / surgery Spiral Ganglion / cytology, physiology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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9004-61-9/Hyaluronic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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