Presented at the Triological Society Combined Sections Meeting, Miami Beach, Florida, U.S.A., January 27, 2012.
Revision cochlear implantation following internal auditory canal insertion
Article first published online: 20 SEP 2013
Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 123, Issue 12, pages 3141–3147, December 2013
How to Cite
Heman-Ackah, S. E., Friedmann, D. R., Cosetti, M. K., Waltzman, S. B. and Roland, J. T. (2013), Revision cochlear implantation following internal auditory canal insertion. The Laryngoscope, 123: 3141–3147. doi: 10.1002/lary.23340
J.T.R. is a member of the Advanced Bionics, Cochlear Americas, and Med El advisory boards.
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 25 NOV 2013
- Article first published online: 20 SEP 2013
- Accepted manuscript online: 5 APR 2012 05:05AM EST
- Manuscript Accepted: 13 MAR 2012
- Manuscript Revised: 9 MAR 2012
- Manuscript Received: 13 JAN 2012
- Cochlear implant;
- pediatric otology;
- congenital anomalies;
- internal auditory canal insertion;
- congenital cochlear anomalies;
- X-linked deafness
In pediatric patients with congenital malformations of the inner ear, anomalies within the anatomy may facilitate unintentional insertion of the cochlear implant electrode into the internal auditory canal. Revision procedures for removal and replacement of cochlear implant electrodes following internal auditory canal insertion are fraught with potential danger, including the theoretical risk of injury to vasculature within the internal auditory canal, repeat insertion within the internal auditory canal, and cerebrospinal fluid leak. The objective of this presentation is to describe a technique for revision cochlear implantation following internal auditory canal insertion to minimize the potential associated risks.
A retrospective chart review was performed on all patients at a tertiary care facility who underwent revision cochlear implantation for internal auditory canal insertion between January 1999 and July 2011.
A total of four patients referred from outside institutions have undergone revision cochlear implantation for internal auditory canal insertion. The records from these patients were reviewed. Electrodes were safely removed in all cases without injury to the anterior inferior cerebellar artery or its branches (i.e., labyrinthine artery). Complete insertion was accomplished on reimplantation. Neural response telemetry was performed in all cases, and responses were noted. Fluoroscopy was utilized to visualize electrode progression during insertion. A detailed description of the operative technique is provided.
This case series describes a technique for revision cochlear implantation that appears to be safe and effective in preventing potential associated complications. Laryngoscope, 123:3141–3147, 2013