The insertion trajectory in cochlear implantation – comparison between two approaches

Abstract

Conclusion. The suprameatal approach (SMA) for cochlear implantation is a safe procedure and is at least comparable to the classic mastoidectomy–posterior tympanotomy approach (MPTA) regarding the possibility of reducing electrode insertion trauma. Objectives. To compare the trajectory in the SMA with insertion through cochleostomy, to the MPTA with round window insertion. Methods: Nine temporal bones were implanted by both techniques, and the point of first contact of a precurved electrode was compared. Results: With the SMA, in all bones, the point of first contact was the inferior wall of the scala tympani and insertion was into the scala tympani. In the MPTA, in five of the bones, the point of first contact was the modiolus, the osseous spiral lamina or the basilar membrane.

Keywords::

• Cochlear implant
• electrode insertion trauma
• suprameatal approach

Acknowledgments

This project was funded in part by Cochlear Europe, which also supplied the sham Nucleus electrodes. The temporal bones and dissection laboratory facilities were supplied by the Practical Otology Society, Experimental Center for Dissection and Research, Paris, France, headed by Dr Andre A. Sultan.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.