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Published on: February 29, 2020
[Cochlear implant approach in children patients with sigmoid sinus antedisplacement]
Xinchun Ma1, Daoxing Zhang, Yankun Zhang
1Department of Otorhinolaryngology, Qinghai Affiliated Hospital to Capital University, Xining, 810001, China.
Insights
Sigmoid sinus antedisplacement is rare in pediatric cochlear implant surgery, affecting less than 1% of cases. Surgeons can manage significant displacement by removing the incus and reducing the posterior bony external auditory canal wall.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Neurosurgery
Background:
- Cochlear implantation is a common procedure for profound hearing loss in children.
- Sigmoid sinus antedisplacement is a potential anatomical variation that may complicate surgery.
- Understanding the incidence and management of this variation is crucial for surgical success.
Purpose of the Study:
- To describe the surgical approach and management strategies for pediatric cochlear implantations in the presence of sigmoid sinus antedisplacement.
- To evaluate the frequency and impact of sigmoid sinus antedisplacement on cochlear implant surgery in children.
Main Methods:
- Retrospective analysis of 538 children undergoing cochlear implantation.
- Preoperative high-resolution CT scans to assess sigmoid sinus position.
- Surgical procedures adapted for cases with significant sigmoid sinus antedisplacement.
Main Results:
- Slight sigmoid sinus antedisplacement (11.9%) did not affect standard cochlear implant procedures.
- Significant sigmoid sinus antedisplacement occurred in 4 cases (0.74%), complicating surgery.
- Successful completion of all 4 complex cases through specific surgical modifications.
Conclusions:
- Significant sigmoid sinus antedisplacement requiring surgical modification is infrequent in pediatric cochlear implant cases.
- Management strategies involving incus removal and bony auditory canal wall reduction are effective.
- These techniques ensure successful cochlear implantation despite anatomical challenges.
Objective:
To summarize the operation approach and management during cochlear implant operation in children with sigmoid sinus antedisplacement.
Method:
Five hundred and thirty-eight profound hearing loss children were performed auditory and imagiological examinations before cochlear implant. We analyzed the location of the sigmoid sinus from the high resolution CT scan and then performed cochlear implant to all these patients.
Result:
In all these 538 cochlear implant children, 4 cases (0.74%) had significant sigmoid sinus antedisplacement which cause the operation more difficult, 64 cases (11.9%) had slight sigmoid sinus antedisplacement which did not impact the ordinary cochlear implant procedures.
Conclusion:
Significant sigmoid sinus antedisplacement that impact cochlear implant operative procedures were seldom happen in children. In 538 cochlear implant children of our center, 4 cases had significant sigmoid sinus antedisplacement that impact cochlear implant operative procedures, we successfully complete these 4 operation through removal of the incus and abrasive reduction the posterior wall of bony external acoustic meatus.
