Endoscopic Assisted Cochlear Implants in a Patient with Difficult Anatomy

By June 7, 2019

Villari, Domenico1
1 University Hospital of Modena, Modena, Italy.

I present a case of a 65 years old lady, already operated bilaterally for Cholesteatoma, who needed cochlear implants because of progressive hearing loss on the right side and suddend hearing loss on the left side that not recovered with therapy.

Was decided to operated the patient n the right side because was the one where she didn’t use the hearing aids.

The preoperative CT scan showed inflammatory tissue in the right middle ear, a procident sigmoid sinus and an high jugular bulb. The MR scan didn’t give more infomation about the nature of material in the tympanic cavity.

Endscopic assisted Approach was choosen in these case:

– Endoscopic step was performed first, to anlalize the inflammatory tissue (only secrection was found) and to locate the rownd window and to prepare the access to the cochear scala tympani
– Suprameatal Microscopic approach was performed to place the array.

The patient had a good result from the surgery wihout any complication

The video is interesting for the showing of anatomical detail and a simple and safe way to avoid coomplication in caseswhere the anatomical findings could be diffucult to understand.