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Revision cochlear implantation following internal auditory canal insertion
Selena E Heman-Ackah1, David R Friedmann, Maura K Cosetti
1Department of Otolaryngology, New York University School of Medicine, New York, New York, U.S.A.
The Laryngoscope
|October 12, 2013
Summary
Revision cochlear implantation for internal auditory canal electrode insertion is complex. A described technique safely removed and replaced electrodes in four pediatric patients, avoiding vascular injury and ensuring successful reimplantation.
Area of Science:
- Otolaryngology, Pediatric Otology, Neurotology
Background:
- Congenital inner ear malformations increase the risk of cochlear implant electrode insertion into the internal auditory canal.
- Revision surgeries for internal auditory canal electrode insertion carry significant risks, including vascular injury and cerebrospinal fluid leaks.
Observation:
- A case series reviewed four pediatric patients requiring revision cochlear implantation due to internal auditory canal electrode insertion.
Findings:
- A specific surgical technique allowed for safe electrode removal without damaging the anterior inferior cerebellar artery or its branches.
- Successful reimplantation was achieved in all cases, with positive neural response telemetry findings.
- Fluoroscopy guided electrode progression during the revision procedure.
Implications:
- This technique offers a safe and effective approach to managing cochlear implant electrode misplacement in pediatric patients with inner ear anomalies.
- Minimizing risks associated with revision surgery is crucial for improving outcomes in pediatric cochlear implantation.
