Surgical techniques of cochlear implantation

Abstract

Introduction. The surgical operation of cochlear implantation is carried out in accordance with a well-determined algorithm, which remained unchanged over the course of 30 years. However, in recent years, many scientists and surgeons believe cochlear implantation surgery should be reviewed, as it requires additional studies. Aim of the study. Analysis of surgical techniques used in cochlear implantation. Materials and methods. The study group includes 14 patients diagnosed with deep congenital bilateral sensorineural hearing loss, operated at the Republican Clinical Hospital, from 2014 through 2017; quotient m:f-1.33:1, aged from one year and a half to 17. Paraclinic preoperative examination: 100% of patients underwent computerized tomography and magnetic resonance imaging, as a result of which one patient was diagnosed with bilateral cochlear hypoplasia (Mondini syndrome); the rest of the patients had no anatomical changes in the inner ear. Surgery for 100% of patients was performed through mastoidotomy and posterior tympanotomy approach. For 3 patients (21.42%), an electrode was introduced into the scale tympani of cochlea through the round window, i.e. through the natural orifice of the cochlea; while for 11 patients (78.58%), it was introduced through an opening new hole milling formed near the round window (through the cochleostomy). In 11 cases we used the cochlear implant of the Med-EL Company, and in 3 cases the cochlear implant of the Cohlear Company. Average surgery duration was one hour and 47 minutes. Average duration of post-operative in-hospital stay was 9.23 days. Results. Out of the total number of patients (n=14), no one suffered of intraoperative complications, and the rate of early and late postoperative complications amounted to 0%. Conclusions. After analyzing surgical techniques used in the cochlear implantation, as well as the rate of early and late postoperative complications, it has been established that this surgical technique continues to be an effective one and does not cause occurrence of complications, despite the fact that it is a classical technique.