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Endoscopic-Assisted Cochlear Implantation via a "Microfacial Recess"
Taseer F Din1, Faisal Abdulkader1, Kay W Chang2
1Division of Pediatric Otolaryngology, Head-Neck Surgery, Department of Surgery, Sidra Medicine, Doha, Qatar.
The Laryngoscope
|June 5, 2024
Summary
This case report details a novel endoscopic cochlear implant (CI) technique for a patient with brachio-oto-renal syndrome. The "microfacial recess" approach successfully navigated severe facial nerve anomalies, enabling CI insertion.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Device Technology
Background:
- Patients with syndromic conditions often present complex anatomical variations that complicate standard cochlear implant (CI) procedures.
- Brachio-oto-renal syndrome is associated with craniofacial anomalies, potentially impacting surgical access to the cochlea.
Observation:
- A 20-year-old patient with brachio-oto-renal syndrome exhibited severe facial nerve malformation obstructing the round window.
- Conventional posterior tympanotomy for CI insertion was not feasible due to the anomalous facial nerve anatomy.
Findings:
- This report introduces the first documented use of an endoscopic trans-canal bony cochleostomy via a "microfacial recess" for CI insertion.
- A modified, narrow posterior tympanotomy into the "microfacial recess" facilitated complete CI electrode placement despite the challenging anatomy.
Implications:
- This endoscopic technique offers a viable alternative for cochlear implantation in patients with syndromic facial nerve anomalies.
- The "microfacial recess" approach may expand CI candidacy for individuals with previously prohibitive surgical obstacles.
