Endoscopic-assisted epitympanic approach: a feasible technique for cochlear implantation

• Published in: The Egyptian journal of otolaryngology Vol. 37; no. 1; pp. 17 - 12
• Main Authors: Badr-El-dine, Mohamed Mostafa, Fathalla, Mohamed Fawzy, Eid, Mohamed, Mehanna, Ahmed Mohamed
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2021; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Cochlear implantation (CI); Cochlear implants; Drilling; Electrodes; Endoscopic ear surgery; Endoscopy; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Methods; Original Article; Otolaryngology; Otology; Round window (RW); Strategic planning (Business); Surgery; Surgical approach; Visualization; Germany; Endoscopic ear surgery; Surgical approach; Round window (RW); Cochlear implantation (CI)
• ISSN: 1012-5574; 2090-8539
• DOI: 10.1186/s43163-021-00084-y

Background The aim of this study is to discuss the detailed surgical steps of the endoscopic-assisted epi-tympanic approach (EAEA) to the round window (RW) as a safe, precise, and reliable approach for cochlear implantation (CI) and also to evaluate possible problems and limitations faced, their management strategies, and how to overcome. Results This study was carried on 40 patients admitted for cochlear implantation (CI). The patients were divided into two equal groups; the first group underwent CI via the endoscopic-assisted epitympanic approach (EAEA), while the second group was a comparison group and underwent CI via the classic posterior tympanotomy. There was a statistical significant difference as regards scalar location of CI electrodes; all EAEA cases were inserted through ST in comparison to 45% of conventional cases. There was no statistical significant difference as regards linear and angular insertion depth between the two groups. The EAEA group needed shorter time to finish the procedure taking from 90 to 195 min, whereas the conventional group consumed longer time ranging from 120 to 185 min; a difference that was found to be statistically significant. No facial nerve injury was reported in the endoscopic approach. Conclusions Endoscope-assisted epitympanic approach (EAEA) is a reliable and safe approach for soft surgery CI. Visualization of the RW and insertion of the electrode under endoscopic control was significantly reliable and successful in all cases.