Veria Operation

Abstract

The ‘Veria operation’ is a new technique for cochlear implantation. It is a non-mastoidectomy technique and uses the endaural approach for the cochleostomy and a direct tunnel drilled through the supero-posterior bony canal wall for the electrode. Two special instruments have been developed for this technique: a special perforator for the drilling of the direct tunnel and a safety electrode forceps for the insertion of the electrode. The method has been used in 101 cases with an age range from 2.5 to 75 years. 78 of them were primary operations and 23 revision cases. From the revisions, 18 were surgical failures and 5 were device failures. There were two complications: in 1 case there was a thick skin flap, which was corrected under local anesthesia, and in 1 malformation case there was a retrograde insertion to the vestibule and the posterior semicircular canal, corrected 6 weeks later. The analysis of the results shows that this method has certain advantages, which are: it is simple and therefore the learning curve is fast; it is safe for the facial nerve, as the drilling is precisely controlled by the special perforator; it produces minimal bone trauma and due to fast healing, it permits early fitting a few days after operation; it is suitable for the difficult and revision cases and it can be used for very small children where the mastoid may have not been yet sufficiently developed.

Surgical considerations in cochlear implantation in children and adults: A review of 342 cases in Vienna

“…An approach through the middle fossa was described by Colletti et al [3] in 1998, Kiratzidis et al [4] drilled a tunnel through the posterio-superior ear canal wall and Häusler [5] revived the direct approach through the external ear canal, which had previously been performed in the very early days of cochlear implantation [6]. In 1999 Kronenberg et al [7] introduced a new non-mastoidectomy technique, the suprameatal approach (SMA).…”

Robotic middle ear access for cochlear implantation: First in man

“…The success story of CIs with about 600.000 implant users worldwide, shows the procedure is widely considered safe and effective [2–4]. Nevertheless, alternative implantation techniques to further improve patient outcomes such as reduced mastoidectomy under endoscopic supervision [5] and endaural implantation techniques have been proposed (e.g., the pericanal, suprameatal, or Veria approaches) [6–8]. However, mastoidectomy followed by a posterior tympanotomy remains the standard surgical approach to the inner ear for cochlear implantation.…”

Residual hearing preservation using the suprameatal approach for cochlear implantation

“…Th is is rather surprising, given the variety of approaches described as alternatives to the standard mastoidectomy posterior tympanotomy (MPTA) technique by House [6]. Alternative techniques for cochlear implantation include endomeatal approaches [7,8], the middle fossa approach [9], the mastoid tunnel technique [10], and the suprameatal approach [11].…”