Minimally Invasive Cochlear Implantation with Mastoidal Three-Layer Flap Technique

• Published in: O.R.L. Journal for oto-rhino-laryngology and its related specialties Vol. 71; no. 5; pp. 292 - 298
• Main Authors: Ulug, Tuncay, Teker, Aysenur Meric
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2009; S. Karger AG
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child, Preschool; Cochlear Implantation - methods; Cochlear implants; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Hearing Loss, Sensorineural - surgery; Humans; Infant; Male; Medical procedures; Medical sciences; Middle Aged; Minimally Invasive Surgical Procedures - methods; Non tumoral diseases; Original Paper; Otorhinolaryngology. Stomatology; Postoperative Complications; Prospective Studies; Surgical Flaps; Young Adult; Minimally invasive surgery; Superficial musculoaponeurotic system; Cochlear implantation; Complications; Surgical technique; Sensorineural hearing loss; Internal ear disease; Auditory disorder; Implantation; ENT; Treatment; Cochlea; ENT disease; Complication; Perception hearing loss; Technique; Flap (surgery); Sensory hearing loss
• ISSN: 0301-1569; 1423-0275
• DOI: 10.1159/000258680

Aims: To describe and evaluate a minimally invasive cochlear implantation approach using mastoidal three-layer flap (TLF) technique. Methods: We conducted a prospective clinical study at a tertiary referral center. The study population comprised 32 males and 16 females, with an age range of 1–51 years. Thirty-nine patients were operated on using the TLF technique and 9 patients were operated on using a classical cochlear implantation technique. The TLF technique was based on using the superficial musculoaponeurotic system (SMAS) as an additional, strong flap layer. The TLF, with 3 different pedicules, comprised an anteriorly based 4-cm skin flap, a superiorly based temporomastoidal flap, which included the SMAS, and an anteriorly based periostal Palva type flap in the same mastoidal area. Results: No major complications, including flap-wound problems and receiver-stimulator migration or extrusion, were encountered. The mean operation time was 66 min in the TLF population and 92 min in the classical operation population, which shows a statistically significant difference noted in the time of operation (p = 0.0001). Conclusion: The TLF cochlear implantation enables complete receiver-stimulator coverage and safe fixation without any additional procedures, while allowing reduced operation time.