What We Learned from a EES-assisted CI Revision Surgery: Case Report

By June 7, 2019

Huang, David Chang-Wei1
1 Department of Otolaryngology – Head and Neck Surgery, Kuang-Tien General Hospital, Taiwan.

Introduction:
A 18-year-old boy underwnt CI surgery owing to traumatic temporal bone fracture with facial palsy and total hearing loss. The poor hearing outcome were noted and followed again temporal bone CT ten months post-operatively and revealed suspected misplaced CI electrolyte into false passage of protympanic Eustachian tube.

Method:
EES-assisted revision surgery was arranged. Operation findings were 3-layer middle ear adhesion and diffuse fibrotic bands, displaced RW location by temporal bone fracture, and confirmed misplaced CI electrolyte into false passage of protympanic Eustachian tube.

Discussion:
The location of RW was not absolutely the same for EES transcanal view and MES trans facial recess observation. Furthermore, the oblique sagittal view CT was very useful to evaluate false passage of protympanic Eustachian tube pre-operatively. After confirm the actual RW location, we removed and replaced CI electrolyte into correct position. The hearing outcome was excellent noted two weeks after revision surgery. Furthermore, it was impossible to deal with the middle ear traumatic adhesion and fibrotic band by MES via facial recess.

Conclusion:
EES-assisted(transcanal remove middle ear adhesion and confirm RW location first) CI was indicated for post-traumatic(especially for temporal bone fracture) patients.