Suprameatal approach for cochlear implantation in 45 Chinese children

The insertion trajectory in cochlear implantation – comparison between two approaches

“…More than 600 SMA procedures have been performed in our institution, and twice as many have been performed worldwide [3][4][5]. In our experience there is no difficulty in electrode insertion, complication rates are comparable with the classic mastoidectomy-posterior tympanotomy approach (MPTA) [3][4][5][6][7], and hearing results are similar to those in other reports [4,5]. Still, the question of potential electrode insertion trauma has not yet been addressed.…”

“…There has been some criticism of this technique regarding the angle of insertion into the scala tympani, by which there is no direct vision into the scala and the possibility of inducing electrode insertion trauma [2]. More than 600 SMA procedures have been performed in our institution, and twice as many have been performed worldwide [3][4][5]. In our experience there is no difficulty in electrode insertion, complication rates are comparable with the classic mastoidectomy-posterior tympanotomy approach (MPTA) [3][4][5][6][7], and hearing results are similar to those in other reports [4,5].…”

Indications and Common Surgical Approaches for Cochlear Implantation in China

“…Unlike other alternatives with limited development, the SMA has the potential to become a true alternative to the classic technique as no major complications have been reported, while it has the following advantages [9][10][11][12] : (1) the temporal bone structure is less destroyed, avoiding the retroauricular bony defects caused by the mastoidectomy; (2) the facial nerve is at a safe distance from the suprameatal tunnel and is protected by the body of the incus; (3) the wide exposure of the middle ear cavity improves maneuverability, which may be more suitable for treatment in an ossified cochlea; (4) the angle of electrode insertion in the SMA is about 30° superior to that of the mastoidectomy posterior tympanotomy approach, which makes electrode insertion much easier in the SMA; (5) the elimination of the mastoidectomy and posterior tympanotomy in the SMA shortens the duration of surgery. These advantages make the SMA increasingly acceptable to both otologists and patients.…”

“…The procedure we perform in China differs from the standard SMA described by Kronenberg et al [9][10][11] in 3 ways [12] .…”

Cochlear implantation surgery in patients with narrow facial recess

“…This approach has been proven to be simple, although injury of the facial nerve and chorda tympani nerve is possible [1,2]. To avoid the risk of facial nerve and chorda tympani nerve injury, there have been several alternative approaches, including the endomeatal approach [3,4], middle fossa approach [5], mastoid tunnel technique (no mastoidectomy) to the middle ear, and the suprameatal approach [6]. However, it is difficult for otological surgeons to perform cochlear implantation surgery in patients with a narrow facial recess.…”