Related Experiment Video
Updated: Aug 7, 2026
08:06
Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Sequential Bilateral Cochlear Implantation via the Transmastoid Labyrinthotomy Approach Using Custom-Made Electrodes
Ciro Lucio Vigliaroli1, Millo Achille Beltrame2, Lazzaro Cassano1
1Department of Otorhinolaryngology and Maxillofacial Surgery, Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy.
Case Reports in Otolaryngology
|August 6, 2026
Summary
Cochlear implantation (CI) in common cavity deformities, a complex inner ear malformation (IEM), can be successful using a double posterior transmastoid labyrinthotomy (TML) approach with custom electrodes. This technique offers safe and effective bilateral CI, leading to improved hearing and language development in pediatric patients.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- Inner ear malformations (IEMs), particularly common cavity deformities, pose significant challenges for cochlear implantation (CI).
- Accurate electrode placement and nerve integrity are crucial for successful surgical and audiological outcomes in these complex cases.
Purpose of the Study:
- To evaluate the efficacy and safety of sequential bilateral cochlear implantation using a double posterior transmastoid labyrinthotomy (TML) approach with custom-made electrodes in a pediatric patient with bilateral common cavity deformities.
Main Methods:
- A pediatric patient with bilateral common cavities and profound sensorineural hearing loss underwent sequential bilateral CI.
- The double posterior TML approach was utilized with custom-made MED-EL FORM19 electrodes tailored to the patient's anatomy.
- Intraoperative neural response telemetry was used to confirm nerve responses.
Main Results:
- Surgical implantation was uneventful with confirmed intraoperative neural responses in both ears.
- Four-year follow-up showed stable aided hearing thresholds in the speech frequency range (Right: 40-60 dB HL, Left: 50-65 dB HL).
- Speech audiometry demonstrated good detection and recognition, with age-appropriate language development and significant improvement from baseline.
Conclusions:
- The double posterior TML approach combined with custom electrodes is a safe and effective strategy for CI in complex IEMs like common cavity deformities.
- This technique facilitates precise electrode placement, minimizes facial nerve risks, and ensures stable fixation.
- Favorable long-term outcomes depend on early bilateral stimulation, family involvement, multidisciplinary care, and tailored electrode design.
