The transmeatal approach: a new technique in cochlear and middle ear implants

The transmeatal approach (TMA) is a new approach for cochlear and middle-ear implantation. It is an open-tunnel technique that differs from closed transcanal non-mastoidectomy approaches. The TMA involves creating an open transcanal tunnel starting from the annulus superior to the chorda tympani laterally towards the suprameatal region. Then, through the open tunnel, a bony groove is created in the bone underneath the length of the external auditory canal (EAC) to protect the electrode from extrusion through the EAC. We report on the use of this approach in 131 patients (115 consecutive paediatric and 16 adult) between May 2004 and December 2007. During 2 to 46 months of follow-up there was no electrode extrusion.