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Endoscope-Assisted Cochlear Implantation in Atretic Round Window
Muhammad Syafiq H Musa1,2, Khairunnisak Misron2, Noor Dina Hashim3
1Otolaryngology - Head and Neck Surgery, Hospital Canselor Tuanku Mukhriz, Kuala Lumpur, MYS.
Cureus
|March 19, 2024
Summary
Endoscopic visualization aided cochlear implant (CI) surgery in a child with a rare atretic round window (RW) anomaly. This technique improved surgical view and ensured successful electrode insertion, minimizing complication risks.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Imaging
Background:
- Cochlear implantation (CI) conventionally uses transmastoid posterior tympanotomy.
- Endoscopy offers enhanced visualization in otologic surgery, particularly for challenging anatomical structures.
- Pediatric CI candidates require precise surgical techniques for optimal outcomes.
Observation:
- A 3-year-old girl with profound hearing loss underwent left CI surgery.
- Preoperative imaging revealed no inner or middle ear abnormalities.
- Microscopic visualization failed to identify the round window (RW) niche, necessitating endoscopic intervention.
- The endoscope identified a possibly atretic RW, guiding electrode insertion via cochleostomy.
Findings:
- Endoscope-assisted CI surgery successfully navigated the atretic RW anomaly.
- Intraoperative impedance and telemetry measurements were within normal limits.
- No intra- or postoperative complications occurred, and the CI functioned well post-activation.
Implications:
- Atretic RW is a rare intraoperative finding during CI surgery.
- Endoscopic guidance is valuable for CI electrode insertion in cases of limited or abnormal RW anatomy.
- This approach can potentially reduce surgical risks and improve outcomes in complex CI cases.
