Implantation of the Completely Ossified Cochlea

George B. Wanna, Matthew L. Carlson, Grégoire S. Blachon, Jack H. Noble, Benoit M. Dawant, Robert F. Labadie, Ramya Balachandran
2013 Otology and Neurotology  
Objectives-To report a novel modification of the cochlear drill-out procedure that utilizes customized microstereotactic frames as drill guides. Patient(s)-A 34-year-old man with an 18-year history of profound bilateral hearing loss and completely ossified cochleae that underwent a prior unsuccessful conventional cochlear drill-out procedure in the contralateral ear. Interventions-Image-guided cochlear implantation using customized microstereotactic frames to drill linear basal and apical
more » ... ar tunnels. Main outcome measures-Transfacial recess cochlear drill-out procedure with full electrode insertion. Results-Two linear paths were drilled using customized microstereotactic frames targeting the proximal and distal basal turn followed by a full split array insertion. Postoperative imaging confirmed two cochlear tunnels straddling the modiolus with adequate clearance of the facial nerve and internal carotid artery. The patient received auditory benefit with device use and did not experience any surgical complication. Conclusions-Successful cochlear implantation in the setting of total scalar obliteration poses a significant challenge. Image guidance technology may assist in navigating the ossified cochlea facilitating safe and precise cochlear tunnel drilling.
doi:10.1097/mao.0b013e31827d8aa0 pmid:23370556 pmcid:PMC3600086 fatcat:x7ejsn2y7zhe5ifnqeqe7pmwli