Cochlear Implant Fixation in Children Using Periosteal Sutures

Abstract

This report describes a simple and effective technique to secure the ICS package for pediatric cochlear implant surgery.

Electrode Migration in Patients with Perimodiolar Cochlear Implant Electrodes

“…Proper fixation of the receiver/stimulator is one of the most important surgical steps [Adunka and Buchman, 2007;Balkany et al, 2009;Davis et al, 2004;Jethanamest et al, 2014;Lee and Driver, 2005;Molony et al, 2010]. Furthermore, a titanium clip or split bridge can be used as a stable fixation point for the electrode array at the incus buttress [Muller et al, 1998;Roland et al, 1998].…”

“…Different techniques to avoid electrode and device migration are known. Proper fixation of the receiver/ stimulator can be achieved by using different flap and subperiosteal pocket techniques [Adunka and Buchman, 2007;Cuda, 2013]. Additional screws and special tips at the receiver/stimulator have been established to avoid movement of the device [Davis et al, 2004;Lee and Driver, 2005;Schnabl et al, 2014].…”

“…Additional screws and special tips at the receiver/stimulator have been established to avoid movement of the device [Davis et al, 2004;Lee and Driver, 2005;Schnabl et al, 2014]. Whether foreign bodies are really necessary to achieve proper fixation of the implant has been widely discussed in the literature [Adunka and Buchman, 2007;Boscolo-Rizzo et al, 2011;Molony et al, 2010]. Additional fixation of the electrode in the facial recess can be achieved using titanium clips [Muller et al, 1998;Roland et al, 1998].…”

Surgical Technique for Implantation of the MED-EL SONATATI¹⁰⁰

“…Cohen [16] advises to use a bony bed and to drill bony holes for sutures. Adunka and Buchman [17] describe a technique for implant device fixation that uses a seat for the device and suture fixation through the native cranial periosteum without complication in 160 pediatric cochlear implant recipients. Also, Molony et al [7] favor a perio steal tie-down technique.…”

Non-sutured fixation of the internal receiver-stimulator in cochlear implantation

“…Although the standard surgical technique is well established [4], minimally invasive and alternative approaches, reducing operating time and surgical morbidity, have recently been described [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. A critical step during surgical procedure is the fixation of the internal receiver-stimulator in order to prevent postoperative implant migration, a device-related major surgical complication occurring approximately in 5% of CIs, despite appropriate intraoperative placement [1,5].…”