Modified sutureless recess/tunnel technique for fixation of the internal receiver-stimulator in cochlear implantation

Author:

Sefein Ihab K.ORCID,Gaballah Mohammad M.ORCID

Abstract

AbstractBackgroundFixation of receiver-stimulator (RS) in cochlear implantation is an important step of surgery, while the technique used is still debatable.Aim of studyThe aim of our study is to evaluate the applicability of our modified recess/tunnel (R/T) fixation technique.Materials and methodsDe novo cases between august 2018 and December 2020 were included. A bony recess was drilled deep to the full thickness of RS. A tunnel was fashioned for the fantail and electrode lead with a groove to slide it without trauma. No tie-down sutures were used. The length between the RS magnet and tragus was measured during follow-up visits.ResultsSeventy-eight patients received the new R/T; 37 (47.4%) were females. Children were 50 (64.1%) with an average age of 4.3 ± 2 years, while adults were 28 (35.9%) with an average age of 36.4 ± 10 years. Right implants were 69 implants while left ones were only 9. The average total operative time was 86 ± 13 min, while the average R/T preparation time was 11 ± 4 min which represents 12.8% of the total operative time. No RS migration, hard. or soft failures were detected. One case had postoperative haematoma originating from the skin, while other minor complications were not related to fixation and were treated medically.ConclusionThe R/T fixation technique provides good fixation to RS, fantail, and electrode lead protection and fixation. The disadvantages of wide exposure especially longer operative time can be avoided with this technique.

Publisher

Springer Science and Business Media LLC

Subject

Otorhinolaryngology

Reference15 articles.

1. Davis BM, Labadie RF, McMenomey SO, Haynes DS (2004) Cochlear implant fixation using polypropylene mesh and titanium screws. Laryngoscope 114(12):2116–2118

2. Pamuk AE, Pamuk G, Jafarov S, Bajin MD, Saraç S, Sennaroğlu L (2018) The effect of cochlear implant bed preparation and fixation technique on the revision cochlear implantation rate. J Laryngol Otol 132(6):534–539

3. De Varebeke SP, Coverts P, Cox T, Deben K, Ketelslagers K, Waelkens B (2012) Fixation of cochlear implants: An evidence-based review of literature. B-ENT 8(2):85–94

4. Advanced Bionics. (2018) Surgeon’s manual for the HiResTM ultra 3D cochlear implant with the HiFocusTM SlimJ and HiFocusTM mid-scala electrodes. https://www.advancedbionics.com/content/dam/advancedbionics/Documents/Regional/US/Professionals/HiRes-Ultra%203D-Surgeons-Manual-FDA.pdf

5. Cochlear. (2021) CochlearTM Nucleus® CI612 cochlear implant with Contour Advance® electrode Physician’s Guide United States of America. https://www.cochlear.com/aab71976-c9e5-42d4-af950841dfe71158/D1144266_4-01_EN_CI612_CAM_PG_web.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE-aab71976-c9e5-42d4-af95-0841dfe71158-mPgf7xT

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