Cochlear implantation using a suprameatal approach in a case of severely contracted mastoid cavity

Abstract

Although cochlear implantation using posterior tympanotomy has been performed worldwide, other alternative approaches might be more beneficial and convenient in some selected cases. Of these, suprameatal approach was reported to be one of useful options in cases with narrow facial recess, anteriorly located facial nerve and an ossified cochlea. We describe a case of cochlear implantation using the modified suprameatal approach in a severely contracted mastoid cavity and suggest another indication of this approach.

Keywords: Cochlear implantation; Mastoid; Suprameatal approach.

Fig. 1

Preoperative temporal bone computed tomography showed prominent sigmoid sinus (arrows) causing contracted mastoid cavity. A: Axial view. B: Coronal view.

Fig. 2

Intraoperative findings (right ear). A: Prominent sigmoid sinus was observed in a contracted mastoid cavity (asterisk). B: Cochleostomy was made via external auditory canal. C: Electrode was introduced through the antrum and full insertion was made. D: Postoperative transorbital view shows correct positioning of the electrode array in the right cochlea.

Fig. 3

TM findings with a small posterior perforation 2 months postoperatively. A: The electrode was visible posterior to the perforation. B: Well-healed TM after 1 month later of tymapnoaplsty with cartilage reinforcement. TM: tympanic membranes.