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Updated: Apr 19, 2026
Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
Cochlear implantation requiring a retrofacial approach to the round window
Kyle P Allen1, Loren J Bartels, Brandon Isaacson
1*Tampa Bay Hearing and Balance Center, Tampa, Florida; and †Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
Objective:
To describe three cases of cochlear implantation utilizing a retrofacial approach to the round window.
Study Design:
Retrospective case review.
Patients:
Three patients with sensorineural hearing loss undergoing cochlear implantation.
Interventions:
Cochlear implantation via a retrofacial approach to the round window.
Results:
Three patients were noted to have inadequate visualization of the round window using a standard posterior tympanotomy at the time of their cochlear implant surgery. A retrofacial approach was performed to provide exposure of the round window to ensure correct placement of the electrode array. Intraoperative photos and postoperative imaging are demonstrated.
Conclusion:
When a laterally or anteriorly positioned facial nerve obscures visualization of the round window, a retrofacial approach is a possible route to visualize the round window.
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