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. 2020 Mar;15(1):41-44.
doi: 10.1016/j.joto.2019.09.003. Epub 2019 Sep 24.

Improvements to the retractor and muscle flap design for minimally invasive cochlear implantation

Riyuan Liu  1 , Zhiping Tan  2 , Jianan Li  1 , Yan Yan  1 , Wei Ren  1 , Miao Zhang  1 , Shiming Yang  1 , Hui Zhao  1
Affiliations

Improvements to the retractor and muscle flap design for minimally invasive cochlear implantation

Riyuan Liu et al. J Otol. 2020 Mar.

Erratum in

Abstract

Objective: The aim of this study was to improve muscle flaps and to evaluate surgical outcomes with the use of a novel specialized retractor, which is a surgical instrument used to locate and shape a bony seat for minimally invasive cochlear implantation.

Methods: 50 patients aged 1-75 years with sensorineural hearing loss who required cochlear implantation were recruited. A small incision (<3 cm) was made, and the novel specialized retractor was used in the study group during cochlear implantation. The incision length, surgical outcomes and operative time were recorded and analyzed.

Results: The incision length, total operative time and drilling bony time were shorter in the study group than in the control group (P < 0.05, respectively). All patients recovered well after the surgery without any severe complications.

Conclusion: The use of a novel specialized retractor standardized the surgical processes of cochlear implantation. The retractor helped locate and control the size of the bony well during bone drilling. The tool reduced the technical difficulty and improved the efficacy of this minimally invasive operation.

Keywords: Cochlear implantation; Minimally invasive surgery; Muscle flap; Retractor.

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Figures

Fig. 1
Fig. 1
A, The red line illustrates the shape of the musculoperiosteal flap, and the green line shows the “S”-shaped incision used in the experimental group. B, The borders of the musculoperiosteal flap (inferior and posterior). C, The musculoperiosteal flap held up by a tweezer.
Fig. 2
Fig. 2
The novel retractor consists of 3 parts, including the operating handle (A), skin retractor plate (B) and positioning plate (C).
Fig. 3
Fig. 3
A, The retractor with drilling and positioning functions was placed between the musculoperiosteal flap and the skull surface. B, Drilling of the bony well. C, Shape of the bony well. D, Modification of the edges. E, Mold of the receiver-stimulator. F, Drilling of the bony well for wire.
Fig. 4
Fig. 4
The surgical area was closed using an intradermal suture.
Fig. 5
Fig. 5
The incision length (A), the total operative time (B) and the time for bone drilling (C) were shorter in the study group than in the control group.
See this image and copyright information in PMC

References

    1. Bajaj Y., Wyatt M., Hartley B. Small postaural incision for paediatric cochlear implantation. Cochlear Implants Int. 2005;6(2):77–84. - PubMed
    1. Balachandran R., Reda F.A., Noble J.H. Minimally invasive image-guided cochlear implantation for pediatric patients: clinical feasibility study. Otolaryngol. Head Neck Surg. 2014;150(4):631–637. - PMC - PubMed
    1. Balkany T.J., Whitley M., Shapira Y. The temporalis pocket technique for cochlear implantation: an anatomic and clinical study. Otol. Neurotol. 2009;30(7):903–907. - PubMed
    1. Caversaccio M., Gavaghan K., Wimmer W. Robotic cochlear implantation: surgical procedure and first clinical experience. Acta Otolaryngol. 2017;137(4):447–454. - PubMed
    1. Dalchow C.V., Werner J.A. A new instrument for minimal access surgery in cochlear implantation. Otol. Neurotol. 2005;26(4):678–679. - PubMed