Surgical techniques for insertion of a multi-electrode implant into a postmeningitic ossified cochlea

Severe ossification within the cochlea occurs in more than 20% of children deafened by meningitis. A multi-electrode cochlear implant can dramatically restore useful hearing to such children, providing it can be inserted satisfactorily within the cochlea. Various surgical techniques for cochlear implantation into an ossifying cochlea are discussed. Partial ossification often can be negotiated by clearing the new bone from the scala tympani or by inserting the array through the scala vestibuli. Total ossification is not a contraindication to the use of a multi-electrode cochlear implant. A method of drilling out the basal cochlear turn without removal of the overlying promontory is proposed. The results of "inlay" insertion into a totally ossified cochlea are evaluated in five ears.