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Endoscopic visualisation of the round window during cochlear implantation

Published online by Cambridge University Press:  04 March 2020

A Jain*
Affiliation:
Department of ENT, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
R Sharma
Affiliation:
Department of ENT, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
J C Passey
Affiliation:
Department of ENT, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
R Meher
Affiliation:
Department of ENT, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
R Bansal
Affiliation:
Department of ENT, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
*
Author for correspondence: Dr Avani Jain, Department of ENT, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi110002, India E-mail: avanijain87@hotmail.com

Abstract

Background

Endoscopes provide a magnified view of the middle ear and visualisation of hidden areas. Otoendoscopes facilitate excellent visualisation of the round window niche during cochlear implantation.

Objective

To compare microscopic and endoscopic visualisation of the round window membrane during cochlear implantation in 20 patients.

Methods

Twenty patients who underwent cochlear implantation were included in the study. After maximum exposure of the round window, the accessibility of the round window membrane was graded according to the St Thomas Hospital classification, first by microscope and then by endoscope.

Results

With the use of the endoscope, visualisation of the round window membrane improved in all the patients as compared to the microscope. The electrode array was inserted via a round window or extended round window approach in all but two cases; the latter cases required bony cochleostomy because of unfavourable anatomy.

Conclusion

The main benefit of endoscope-assisted cochlear implantation is improved visibility of the round window region.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Dr A Jain takes responsibility for the integrity of the content of the paper

References

Lloyd, SK, Kasbekar, AV, Kenway, B, Prevost, T, Hockman, M, Beale, T et al. Developmental changes in cochlear orientation--implications for cochlear implantation. Otol Neurotol 2010;31:902–7CrossRefGoogle ScholarPubMed
Leong, AC, Jiang, D, Agger, A, Fitzgerald-O'Connor, A. Evaluation of round window accessibility to cochlear implant insertion. Eur Arch Otorhinolaryngol 2013;270:1237–42CrossRefGoogle ScholarPubMed
Marchioni, D, Soloperto, D, Guarnaccia, MC, Genovese, E, Alicandri-Ciufelli, M, Presutti, L. Endoscopic assisted cochlear implants in ear malformations. Eur Arch Otorhinolaryngol 2015;272:2643–52CrossRefGoogle ScholarPubMed
Marchioni, D, Alicandri-Ciufelli, M, Pothier, DD, Rubini, A, Presutti, L. The round window region and contiguous areas: endoscopic anatomy and surgical implications. Eur Arch Otorhinolaryngol 2015;272:1103–12CrossRefGoogle ScholarPubMed
Rajan, P, Teh, HM, Prepageran, N, Kamalden, TIT, Tang, IP. Endoscopic cochlear implant: literature review and current status. Curr Otorhinolaryngol Rep 2017;5:268–74CrossRefGoogle Scholar
Roland, PS, Wright, CG, Isaacson, B. Cochlear implant electrode insertion: the round window revisited. Laryngoscope 2007;117:1397–402CrossRefGoogle ScholarPubMed
Dia, A, Nogueira, JF, O'Grady, KM, Redleaf, M. Report of endoscopic cochlear implantation. Otol Neurotol 2014;35:1755–8CrossRefGoogle ScholarPubMed
Migirov, L, Shapira, Y, Wolf, M. The feasibility of endoscopic transcanal approach for insertion of various cochlear electrodes: a pilot study. Eur Arch Otorhinolaryngol 2015;272:1637–41CrossRefGoogle ScholarPubMed
Tarabichi, M, Nazhat, O, Kassouma, J, Najmi, M. Endoscopic cochlear implantation: call for caution. Laryngoscope 2016;126:689–92CrossRefGoogle ScholarPubMed
Marchioni, D, Grammatica, A, Alicandri-Ciufelli, M, Genovese, E, Presutti, L. Endoscopic cochlear implant procedure. Eur Arch Otorhinolaryngol 2014;271:959–66CrossRefGoogle ScholarPubMed