Posterior semi-circular canal electrode misplacement in Goldenhar’s syndrome

Castellino, Ashish; Rayamajhi, Pabina; Kurkure, Rahul; Kameswaran, Mohan

doi:10.1080/14670100.2020.1802905

Cited by 4 publications

(6 citation statements)

References 21 publications

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“…Other documented sites of electrode misplacement include the eustachian tube, internal carotid artery, carotid canal, internal auditory canal, horizontal semicircular canal, hypotympanum, and Hyrtl's fissure. Misplacement of the electrode array into the PSCC was identified in only one other published report, involving a child with Goldenhar syndrome 3 …”

Section: Discussionmentioning

confidence: 99%

“…Misplacement of the electrode array into the PSCC was identified in only one other published report, involving a child with Goldenhar syndrome. 3 Congenital malformations of the inner ear have been identified as the most common predisposing factor for electrode array misplacement. Preoperative highresolution computed tomography scanning should detect gross malformations such as cochlear aplasia or complete labyrinthine aplasia, but cannot exclude minor anatomical variations such as malformation of the osseous spiral lamina.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Cochlear Implant Electrode Array Misplacement Into the Posterior Semicircular Canal

2022

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Cochlear implant electrode array misplacement is a rare but serious complication that may result in failure of hearing rehabilitation, non-auditory percepts, vestibular disturbance, or damage to adjacent neurovascular structures. We present a case of an elderly patient who suffered electrode array misplacement into the posterior semicircular canal, resulting in vestibular symptoms and severe downstream sequelae. The risk of misplacement may be higher in patients with a history of chronic otitis media or prior otologic surgery, and with the use of pre-curved electrode arrays. Electrophysiological testing and intraoperative imaging may allow for early detection and intervention in these cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Cochlear Implant Electrode Array Misplacement Into the Posterior Semicircular Canal

2022

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“…palatal abnormalities. 5 In our case, the atretic plate was drilled to access the middle ear directly, using the middle fossa as a landmark. The removal of the malleo-incudal complex further allowed better access for the cochleostomy.…”

Section: Intra-operative Considerationsmentioning

confidence: 94%

“…Case 4 had bilateral microtia, and only the contralateral ear was atretic. 5 Case 5 had bilateral complete AA and grade 3 microtia with right facial paresis 6 (Table 1).…”

Section: Methodsmentioning

confidence: 99%

The role for cochlear implants in microtia and congenital aural atresia: A case report and a review of literature

Neo

Tan

et al. 2023

Proceedings of Singapore Healthcare

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Sensorineural hearing loss resulting from microtia and aural atresia is rare due to different embryologic origins of the external and inner ear. Consequently, cochlear implants are seldom performed in patients with microtia and/or aural atresia. Herein we discuss an 8 year-old boy with congenital aural atresia and microtia who underwent cochlear implant surgery for profound hearing loss with good results. A literature review was performed and discussed. Pre-operative planning with high resolution computed tomography and facial nerve monitoring are crucial in identification and preservation of the facial nerve due to the high rate of aberrant anatomy. Careful incision placement is required particularly if pinna reconstruction is considered. Literature review highlighted various surgical approaches as well as different modalities used for intra-operative facial nerve monitoring. Only one patient had intra-operative complications. Cochlear implant is a viable solution in patients with external ear malformations and severe-profound sensorineural hearing loss. Adequate planning and counselling are essential due to the challenges that may occur in microtia and aural atresia.

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“…Suboptimally positioned cochlear implant (CI) electrodes can result in impaired speech perception (3)(4)(5). Rare instances where the electrode array has been misplaced entirely into extracochlear locations including the vestibule, semicircular canals, internal carotid canal, and eustachian tube have been reported in both malformed (6) and normal inner ears (7). Misplacement may be identified on postoperative investigations rather than during the intraoperative setting.…”

mentioning

confidence: 99%

Misplaced Cochlear Implant Electrodes Outside the Cochlea: A Literature Review and Presentation of Radiological and Electrophysiological Findings

Cheung

Kong

Chu

et al. 2022

Otology &Amp; Neurotology

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Hypothesis:It is possible to detect when misplacement and malposition of the cochlear implant (CI) electrode array has occurred intraoperatively through different investigations. We aim to explore the literature surrounding cochlear implant misplacements and share our personal experience with such cases to formulate a quick-reference guide that may be able to help cochlear implant teams detect misplacements early.Background:Misplacement and malposition of a cochlear implant array can lead to poor hearing outcomes. Where misplacements go undetected during the primary surgery, patients may undergo further surgery to replace the implant array into the correct intracochlear position.Methods:Systematic literature review on cochlear implant misplacements and malpositions and a retrospective review of our program's cases in over 6,000 CI procedures.Results:Twenty-nine cases of CI misplacements are reported in the English literature. Sixteen cases of cochlear implant misplacements are reported from our institution with a rate of 0.28%. A further 12 cases of intracochlear malpositions are presented. The electrophysiological (CI electrically evoked auditory brainstem response, transimpedance matrix) and radiological (X-ray and computed tomography scan) findings from our experience are displayed in a tabulated quick-reference guide to show the possible characteristics of misplaced and malpositioned cochlear implant electrode arrays.Conclusion:Both intraoperative electrophysiological and radiological tests can show when the array has been misplaced or if there is an intracochlear malposition, to prompt timely intra-operative reinsertion to yield better outcomes for patients.

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Posterior semi-circular canal electrode misplacement in Goldenhar’s syndrome

Cited by 4 publications

References 21 publications

A Rare Case of Cochlear Implant Electrode Array Misplacement Into the Posterior Semicircular Canal

A Rare Case of Cochlear Implant Electrode Array Misplacement Into the Posterior Semicircular Canal

The role for cochlear implants in microtia and congenital aural atresia: A case report and a review of literature

Misplaced Cochlear Implant Electrodes Outside the Cochlea: A Literature Review and Presentation of Radiological and Electrophysiological Findings

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