Fossa incudis approach in cochlear implant surgery: safe and easy technique for facial nerve preservation during posterior tympanotomy

Abdussalam Mohamed Jahan; Mohamed Omar Zaggot

doi:10.18203/issn.2454-5929.ijohns20260062

Authors

Abdussalam Mohamed Jahan Misurata Medical Center, Misrata, Libya
Mohamed Omar Zaggot Misurata Medical Center, Misrata, Libya

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20260062

Keywords:

Cochlear implant, Fossa incudis approach, Facial nerve injury

Abstract

Background: Cochlear implant surgery became worldwide operation used to manage patients with severe to profound sensory neural hearing loss that were not benefit from hearing aids. Facial nerve (FN) injury during the surgery still the most complication that the surgeons think about it during doing posterior tympanotomy.

Methods: A retrospective study including 76 patients complaining of severe to profound SNHL, get implanted in Misrata Medical Center, Misrata city, Libya, in the period between January 2018 and April 2020, using our new technique: Fossa incudis approach (FIA), in which and after cortical mastoidectomy performed, exposure of tip of short process of incus which situated in fossa incudis was done to become guide and help us to enter middle ear safe.

Results: After 76 operations performed on 76 patients with different anatomical situations, we report 0% FN injury. The time of surgery was relatively shorter (90 minutes±10).

Conclusions: Our technique (FIA) is safe and easy to learn; it helps us to minimize the incidence of FN injury and decrease the time of operation.

Metrics

Metrics Loading ...

Author Biography

Abdussalam Mohamed Jahan, Misurata Medical Center, Misrata, Libya

ent department

References

Copeland BJ, Pillsbury HC. Cochlear implantation for the treatment of deafness. Annu Rev Med. 2004;55:157-67. DOI: https://doi.org/10.1146/annurev.med.55.091902.105251

Hehar SS, Nikolopoulos TP, Gibbin KP, O’Donoghue GM. Surgery and functional out come in deaf children receiving cochlear implants befpre age 2 years. Arc Otolaryngol Head Neck Surg. 2002;128(1);11-4. DOI: https://doi.org/10.1001/archotol.128.1.11

Raghunandhan S, Mohan Kameswaran RS, Kumar A, Agarwal AK, Hossain MD. A study of complications and morbidity profile in cochlear implantation. Indian J Otolaryngol Head Neck Surg. 2014;66(1):161-8. DOI: https://doi.org/10.1007/s12070-011-0387-3

Das S, Buchman CA. Bilateral cochlear implantation: current concepts. Curr Opinion Otolaryngol Head Neck Surg. 2005;13(5):290-3. DOI: https://doi.org/10.1097/01.moo.0000179808.00638.ab

Tait M, de Raeve L, Nikolopoulos TP. Deaf children with cochlear implants before the age of 1 year: comparison of preverbal communication with normally hearing children. Int J Pediatr Otorhinolaryngol. 2007;71(10):1605-11. DOI: https://doi.org/10.1016/j.ijporl.2007.07.003

Jappel A, Wolf Dieter B, Kronenberg J, Grossschmidt K, Frei K, Stach M, et al. Histological evaluation of suprameatal approach (SMA) in cochlear implant surgery. Int Congress Series. 2004;1273:115-7. DOI: https://doi.org/10.1016/j.ics.2004.08.096

Kim CW, Oh SJ, Kim HS, Ha SH, Rho YS. Analysis of axial temporal bone computed tomography scans for performing a safe posterior tympanotomy. Eur Arch Otorhinolaryngol. 2008;265:887-91. DOI: https://doi.org/10.1007/s00405-007-0555-y

Jeon EJ, Jun B, Song JN, Kim JE, Lee DH, Chang KH. Surgical and radiologic anatomy of a cochleostomy produced via posterior tympanotomy for cochlear implantation based on three-dimensional reconstructed temporal bone CT images. Surg Radiol Anat. 2013;35:471-5. DOI: https://doi.org/10.1007/s00276-012-1061-5

Calli C, Pinar E, Oncel S, Tatar B, Tuncbilek MA. Measurements of the facial recess anatomy: implications for sparing the facial nerve and chorda tympani during posterior tympanotomy. Ear Nose Throat J. 2010;89:490-4.

Kronenberg J, Fuchs C, Bendet E. Preoperative radiologic assessment of facial nerve in cochlear implant surgery. Eur Arch Otorhinolaryngol. 1994;353-5. DOI: https://doi.org/10.1007/978-3-642-85090-5_126

Mostafa BE, Ezzat WF, El Mogui AM. The modified transcanal approach for cochlear implantation: technique and results. Advan Otolaryngol. 2014;509703:1-5. DOI: https://doi.org/10.1155/2014/509703

Arnoldner C, banmgartner WD, Gstoettner W, Hanzavi J. Surgical consideration in cochlear implantation in children and adults: a review of 342 cases in Vienna. Acta otolaryngol. 2003;125(3):228-34. DOI: https://doi.org/10.1080/00016480410022895

Migirov L, Dagan E, Kronenberg J. Surgical and medical complications in different cochlear implant devices. Otoneurology. 2009;129:741-4. DOI: https://doi.org/10.1080/00016480802398954

Brito R, Monteiro TA, Leal AF, Tsuji RK, Pinna MH, Bento RF. Surgical complications in 550 consecutive cochlear implant complications. Braz J Otorhinolaryngol. 2012;78(3):80-5. DOI: https://doi.org/10.1590/S1808-86942012000300014

Ajalloueyan M, Amirsalari S, Yousefi A. Report of surgical complications in a series of 262 consecutive pediatric cochlear implantations in Iran. Iran J Pediatr. 2011;21:455-60.

Jeppesen J, Faber Ce. Surgical Complications Following Cochlear Implantation In Adults Based On A Proposed Reporting Consensus. Acta Otolaryngol. 2013;133(10):1012-21. DOI: https://doi.org/10.3109/00016489.2013.797604