New Approach for Cochlear Implantation: Cochleostomy Through the Middle Fossa

Author:

Colletti Vittorio1,Fiorino Francesco G.1,Carner Marco1,Sacchetto Luca1,Giarbini Nadia21

Affiliation:

1. ENT Department, University of Verona

2. Verona, Italy

Abstract

The middle fossa approach was used in 11 patients with profound bilateral hearing loss for insertion of a cochlear implant. Fibroadhesive otitis media (n = 1), bilateral cavity radical mastoidectomy (n = 1), autoimmune inner ear disease (n = 2), previous cranial trauma (n = 1), genetic prelingual deafness (n = 5), and otosclerosis (n = 1) were the causes of deafness. A cochleostomy was performed on the most superficial part of the basal turn, and the electrode array was inserted up to the cochlear apex. Speech perception tests (1-9 months after cochlear implant activation) yielded better results in these patients compared with a homogeneous group of postlingually deaf patients operated on through the traditional transmastoid route. Insertion of the implant through the middle fossa cochleostomy furnishes the possibility of stimulating areas of the cochlea (ie, the middle and apical turns) where a greater survival rate of spiral ganglion cells is known to occur, with improvement of information regarding the formants relevant for speech perception. (Otolaryngol Head Neck Surg 2000;123:467-74.)

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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