Document Detail

An evaluation of the risk of cerebrospinal fluid leakage as a function of the surgical approach to the cochlear nerve.
MedLine Citation:
PMID:  16826075     Owner:  NLM     Status:  MEDLINE    
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.
Brian Thomas Miller; Todd Hillman
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  116     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-07     Completed Date:  2006-08-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1276-8     Citation Subset:  IM    
Division of Otolaryngology, University of Utah, Salt Lake City, Utah 84132, USA.
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MeSH Terms
Aged, 80 and over
Cerebrospinal Fluid Otorrhea / etiology*
Cochlear Implantation / adverse effects*
Intraoperative Complications
Middle Aged
Risk Factors

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