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Review
. 2022 Feb 25;12(2):113-125.
doi: 10.3390/audiolres12020014.

Subtotal Petrosectomy (SP) in Cochlear Implantation (CI): A Report of 92 Cases

Ignacio Arístegui  1 , Gracia Aranguez  2 , José Carlos Casqueiro  3 , Manuel Gutiérrez-Triguero  4 , Almudena Del Pozo  4 , Miguel Arístegui  5
Affiliations
Review

Subtotal Petrosectomy (SP) in Cochlear Implantation (CI): A Report of 92 Cases

Ignacio Arístegui et al. Audiol Res. .

Abstract

In most cases, cochlear implantation is a straightforward procedure. Nevertheless, there are clinical situations in which the presence of the middle ear may compromise access and/or the outcome in terms of complications. This article includes a series of patients for whom we eliminated the middle ear to facilitate placement of the electrode array of the implant and/or reduce potential complications. A total of 92 cases in 83 patients, managed by the senior author, are included in this series. Different indications are outlined that justify associating a subtotal petrosectomy technique with cochlear implantation. The steps of the technique are described. We include complications from this series that compare favorably with standard techniques.

Keywords: Ménière’s disease; chronic otitis media; cochlear implantation; complex cases in cochlear implantation; complications in cochlear implantation; inner ear malformations; petrous bone cholesteatoma; subtotal petrosectomy; temporal bone fracture; vestibular schwannoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Subtotal petrosectomy. (a) Wide retroauricular incision with 360° sectioning of EAC. (b) Blind sac closure of EAC. (c) Second layer closure with tragal cartilage. (d) Musculoperiosteal incision U-shaped pedicle superiorly. (e) Musculoperiosteal flap reflected superiorly. (f) Elimination of temporal bone cells as required. (g) Placement of the implant and insertion of electrode array. (h) Fat is used to obliterate the cavity. (i) Musculoperiosteal flap repositioned. (j) Tight closure of periosteal flap.
Figure 1
Figure 1
Subtotal petrosectomy. (a) Wide retroauricular incision with 360° sectioning of EAC. (b) Blind sac closure of EAC. (c) Second layer closure with tragal cartilage. (d) Musculoperiosteal incision U-shaped pedicle superiorly. (e) Musculoperiosteal flap reflected superiorly. (f) Elimination of temporal bone cells as required. (g) Placement of the implant and insertion of electrode array. (h) Fat is used to obliterate the cavity. (i) Musculoperiosteal flap repositioned. (j) Tight closure of periosteal flap.
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References

    1. Chandrá S., Roustan V., Piras G., Caruso A., Lauda L., Sanna M. Subtotal Petrosectomy: Surgical technique, indications, otcomes, and comprehensive review of the literature. Laryngoscope. 2017;127:2833–2842. - PubMed
    1. Issing P.R., Schönermark M.P., Winkelmann S., Kempf H.G., Ernst A., Lenarz T. Cochlear implantation in patients with chronic otitis: Indications for subtotal petrosectomy and obliteration of the middle ear. Skull Base. 1998;8:127–131. doi: 10.1055/s-2008-1058571. - DOI - PMC - PubMed
    1. Bendet E., Cerenko D., Linder T.E., Fisch U. Cochlear implantation after subtotal petrosectomies. Eur. Arch. Oto-Rhino-Laryngol. 1998;255:169–174. doi: 10.1007/s004050050037. - DOI - PubMed
    1. Free R.H., Falcioni M., Di Trapani G., Giannuzzi A.L., Russo A., Sanna M. The Role of Subtotal Petrosectomy in Cochlear Implant Surgery–A Report of 32 Cases and Review on Indications. Otol. Neurotol. 2013;34:1033–1040. doi: 10.1097/MAO.0b013e318289841b. - DOI - PubMed
    1. Barañano C.F., Kopelovich J.C., Dunn C., Gantz B.J., Hansen M. Subtotal Petrosectomy and Mastoid Obliteration in Adult and Pediatric Cochlear Implant Recipients. Otol. Neurotol. 2013;34:1656–1659. doi: 10.1097/MAO.0b013e3182a006b6. - DOI - PMC - PubMed

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