Document Detail


Surgical results of cochlear implantation in malformed cochlea.
MedLine Citation:
PMID:  16788416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report the surgical aspects of cochlear implantation in malformed cochlea. SETTING: Tertiary care center. STUDY DESIGN: Retrospective case review. METHODS: Between November 1997 and October 2004, 20 patients with inner ear malformations were implanted in our department. The age range was between 2 and 37 years (average, 8.8 yr). The anomalies were classified according to Sennaroglu and Saatci classification. There were two patients with common cavity deformity, four cases of incomplete partition (IP) type I (cystic cochleovestibular malformation), four cases of IP type II (classical Mondini's deformity), nine patients with large vestibular aqueduct (LVA) syndrome, and one patient with X-linked deafness. RESULTS: Standard transmastoid facial recess approach was used in 17 patients (three patients with IP I, four patients with IP II, and nine patients with LVA syndrome). In the remaining patient with IP I, because of the dehiscent and anteriorly located facial nerve, the surgical approach had to be modified, and an anteroposterior approach was used. After elevating the tympanomeatal flap, the electrode was inserted through the ear canal and then transferred to the mastoid through a full-length cut produced in the ear canal. The flap then returned to its place. In the patients with common cavity deformity, the electrode was inserted by the transmastoid labyrinthotomy approach. Facial nerve had an abnormal course in four patients, but no patient had facial weakness postoperatively. Cerebrospinal fluid gusher was encountered in four patients, whereas oozing was present in five patients. It seems that a slightly larger cochleostomy may reduce postoperative rhinorrhea. The patient with common cavity deformity showed abnormal vestibular stimulation which decreased and was totally abolished during a 3-month period. CONCLUSION: Based on these findings, cochlear implantation is surgically feasible in patients with common cavity, IP types I and II, and LVA. The surgeon should be ready to make modifications in the surgical approach because of the abnormal course of the facial nerve and be ready to produce special precautions to cerebrospinal fluid gusher.
Authors:
Levent Sennaroglu; Sarp Sarac; Turan Ergin
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Publication Detail:
Type:  Case Reports; 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:  27     ISSN:  1531-7129     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-26     Completed Date:  2007-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  615-23     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hacettepe University, Ankara, Turkey. lsennar@tr.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebrospinal Fluid Otorrhea / complications,  surgery
Child
Child, Preschool
Cochlea / abnormalities*,  surgery*
Cochlear Implantation / methods*
Cochlear Nerve / abnormalities
Deafness / surgery*
Facial Nerve / abnormalities
Female
Humans
Infant
Magnetic Resonance Imaging
Male
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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