The transmeatal approach: a new technique in cochlear and middle ear implants

Taibah, Khalid

doi:10.1002/cii.357

Cited by 11 publications

(19 citation statements)

References 9 publications

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“…A follow-up after surgery, we confirmed that patency of the EAC was maintained and the electrodes' function was normal. A study including 131 patients who underwent CI using the transmeatal approach with followup of 2 to 46 months reported no electrode extrusion in the cartilage area [8]. A study with long-term follow-up is necessary to confirm favorable outcomes at the cartilage site.…”

Section: Discussionmentioning

confidence: 99%

“…In conventional CI, canal wall-up mastoidectomy and posterior tympanotomy have been used; in addition, a transmeatal approach to insert the electrode array through the external auditory canal (EAC) has been proposed [8]. This technique involves bypass of the mastoid cavity, which can improve the suprameatal approach [9].…”

Section: Introductionmentioning

confidence: 99%

“…This technique involves bypass of the mastoid cavity, which can improve the suprameatal approach [9]. The other advantages of the transmeatal approach are as follows: first, there is no risk of facial nerve injury because mastoidectomy is not performed; second, the method can be performed in cases with a narrow facial recess, high jugular bulb, or inferior orientation of the round window niche; third, the transmeatal approach allows direct access to the electrode insertion site through the open tunnel drilled in the EAC [8]. In our study, we used the transmeatal approach for insertion of the electrodes, since we observed prominent vessel overgrowth at the mastoid cavity in our patient, which interfered with the conventional approach.…”

Section: Introductionmentioning

confidence: 99%

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Cochlear Implantation via the Transmeatal Approach in an Adolescent with Hunter Syndrome—Type II Mucopolysaccharidosis

Kim

Choo

et al. 2021

J Audiol Otol

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Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare Xlinked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cochlear Implantation via the Transmeatal Approach in an Adolescent with Hunter Syndrome—Type II Mucopolysaccharidosis

Kim

Choo

et al. 2021

J Audiol Otol

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“…The transmeatal approach provides an excellent view to the round window and involves drilling a tunnel visibly in the external canal [10]. However, electrode extrusion, external infection with persistent otorrhea, and cholesteatoma are complications that may arise from the transmeatal approach.…”

Section: Discussionmentioning

confidence: 99%

Trans-Aditus Approach: An Alternative Technique for Cochlear Implantation

Sanosi

2012

Indian J Otolaryngol Head Neck Surg

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The objective of this study was to report our preliminary experience with an alternative technique for cochlear implantation. Twenty patients underwent cochlear implantation via a trans-aditus ad antrum approach to the round window. The main steps involved in the surgical procedure are cortical mastoidectomy, elevation of tympanomeatal flap, incudostapedial joint dislocation, incus removal, preparation of a bed for the implant, cochleostomy via the external auditory canal, and finally insertion of the electrode into the cochlea via the aditus. Twenty-five implants were performed on 20 patients, 18 children (mean age of 3.2 years) and 2 adults. Twelve patients were males and eight were females. All the children were pre-lingual while the adults were post-lingual. Nucleus freedom cochlear implant system (Cochlear, Lane Cover, NSW, Australia) was used in four patients and a cochlear Nucleus 5 was used in six patients. A Med-el SONATA implant (MED-EL, Innsbruck, Austria) was used in 15 patients. The minimum follow-up was 5 months. Here, we describe a new alternative technique for cochlear implantation and report our preliminary results. The procedure has advantages over the existing techniques and avoids the potential complications of posterior tympanotomy, transcanal, and transmeatal techniques.

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“…Taibah K, reported 5 cases out of 134 case of tympanic membrane perforation that was healed spontaneously with conservative measures (9).…”

Section: -Tympanic Membrane Affectionmentioning

confidence: 99%

Comparative Study Between Suprameatal Approach and Posterior Tympanotomy Approach in Cochlear Implantation

Elfeky

Mubashira

Mostafa

et al. 2014

Zagazig University Medical Journal

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Background: Cochlear implant is established as an effective and safe method of rehabilitation for profoundly deaf patients. There are two common surgical approaches for cochlear implantation. The first surgical approach, with mastoidectomy and posterior tympanotomy, is known as the classic approach or posterior tympanotomy approach. The second surgical approach, without mastoidectomy or posterior tympanotomy, is known as the suprameatal approach. Using the suprameatal approach, the active electrode is inserted and posterior tympanotomy. Aim of the work: To compare between suprameatal approach and posterior tympanotomy approach in cochlear implantation. Patients and methods: This study was conducted on 30 patients that underwent cochlear implantation surgery in Zagazig University Hospital, in the period from October 2010 to April 2014. The patients were 19 males and 11 females, their age ranged from 2 to 7 years. Patients were divided to 2 groups: one group was implanted by the supra meatal approach (6 patients) and the other one was implanted by posterior tympanotomy approach (24 patients). Results: There was a significant difference between the 2 groups as regard the total duration of surgery in favor of 1 st group A (SMA). There was no significant difference between the 2 groups as regard the total number of major or minor complications. But there was one case of facial nerve paralysis in a child implanted by the classic approach. Conclusion: SMA may be clearly a good alternative to the classical surgery technique for CI in terms of reducing the duration of surgery and reducing the incidence of facial and chorda tympani nerve injury.

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The transmeatal approach: a new technique in cochlear and middle ear implants

Cited by 11 publications

References 9 publications

Cochlear Implantation via the Transmeatal Approach in an Adolescent with Hunter Syndrome—Type II Mucopolysaccharidosis

Cochlear Implantation via the Transmeatal Approach in an Adolescent with Hunter Syndrome—Type II Mucopolysaccharidosis

Trans-Aditus Approach: An Alternative Technique for Cochlear Implantation

Comparative Study Between Suprameatal Approach and Posterior Tympanotomy Approach in Cochlear Implantation

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