| An evaluation of the risk of cerebrospinal fluid leakage as a function of the surgical approach to the cochlear nerve. | |
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MedLine Citation:
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PMID: 16826075 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Direct implantation into the cochlear nerve can bypass the potential limitations of conventional cochlear implants. Implantable electrical arrays increase the number of stimulation sites, broaden frequency selectivity, require less activating current, and are not dependent on cochlear anatomy. Cochlear nerve implantation demands a unique surgical exposure to the modiolus. This study comprises an assessment of the risk of generating an intraoperative cerebrospinal fluid (CSF) leak using this approach. METHODS: Five fresh cadavers were obtained for dissection. Using dyed normal saline as an indicator, the central nervous system was pressurized to physiological parameters. Surgical approaches to the cochlear nerve were initiated. Leakage of indicator fluid for each approach was quantitatively and qualitatively assessed. Indicator dye in the surgical field was considered a CSF breech. Indicator fluid was collected and quantified. RESULTS: Eighty percent of the surgical approaches caused quantifiable leaks with rates ranging from 0.1 mL/minute to 6 mL/minute. For directly implanted microarrays, the utilization of a modified facial recess approach with cochleostomy and modiolar drillout carries significant risk for generating a CSF leak during the procedure. |
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Authors:
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Brian Thomas Miller; Todd Hillman |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Laryngoscope Volume: 116 ISSN: 0023-852X ISO Abbreviation: Laryngoscope Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-07-07 Completed Date: 2006-08-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 1276-8 Citation Subset: IM |
Affiliation:
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Division of Otolaryngology, University of Utah, Salt Lake City, Utah 84132, USA. btm132@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged, 80 and over Cadaver Cerebrospinal Fluid Otorrhea / etiology* Cochlear Implantation / adverse effects* Female Humans Intraoperative Complications Male Middle Aged Risk Factors |
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