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Transcanal cochlear implantation under monitored anesthesia care.
Hamid R Djalilian1, Saswata Roy, Aaron G Benson
1Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago, Illinois, USA. skullbasesurgery@yahoo.com
Summary
Transcanal cochlear implantation under local anesthesia with monitored anesthesia care is feasible for elderly patients with cardiovascular disease. This approach avoids general anesthesia risks, demonstrating a safe alternative for high-risk individuals.
Area of Science:
- Otolaryngology
- Anesthesiology
- Cardiology
Background:
- Elderly patients with cardiovascular disease face increased risks with general anesthesia.
- Cochlear implantation is a crucial procedure for hearing restoration.
Purpose of the Study:
- To assess the feasibility of transcanal cochlear implantation under local anesthesia with monitored anesthesia care.
- To evaluate this technique in a high-risk elderly patient.
Main Methods:
- A 70-year-old male with significant cardiovascular disease (post-CABG, ASA Class III) underwent the procedure.
- Local anesthesia combined with intravenous remifentanil and dexmedetomidine for monitored anesthesia care was employed.
- The pericanal electrode technique was utilized.
Main Results:
- The 60-minute procedure was successfully completed without adverse cardiac events.
- The patient remained hemodynamically stable, showing no tachycardia, hyper/hypotension, or cardiac ischemia.
- The chosen anesthetic regimen proved effective and well-tolerated.
Conclusions:
- Transcanal cochlear implantation under local anesthesia with monitored anesthesia care is a viable option for patients at high risk for general anesthesia.
- This technique offers a safer alternative for hearing restoration in vulnerable patient populations.