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. 2022 May;18(3):210-213.
doi: 10.5152/iao.2022.21435.

Landmarks for Proper Round Window Electrode Insertion in Cochlear Implantation

Lobna El Fiky  1 , Badr Eldin Mostafa  1 , Samer Ahmed Ibrahim  1 , Ahmed Abdelmoneim Teaima  1
Affiliations

Landmarks for Proper Round Window Electrode Insertion in Cochlear Implantation

Lobna El Fiky et al. J Int Adv Otol. 2022 May.

Abstract

Background: This study aimed to evaluate the role of landmarks for proper round window electrode insertion in cochlear implantation surgery.

Methods: This is a case series study. We included 150 patients undergoing cochlear implantation in a tertiary medical center during the period from January to December 2019. Patients with inner ear malformations or ossification or revision surgery were excluded. Three surgeons partici- pated in the study. During surgery, the round window electrode insertion was marked using 5 surgical landmarks: oval window, pyramid, fustis, round window membrane, and arborization of intracochlear blood vessels. Each surgeon reported on the identification of each landmark and its reliability for round window electrode insertion.

Results: Oval window and round window membrane were clearly seen by the 3 surgeons in all cases. Pyramid was seen in 94% of cases, fustis in 85%, and intracochlear wall in 90% of cases. The postoperative transorbital x-ray confirmed the intracochlear position of electrodes in all cases.

Conclusion: Round window electrode insertion can be precisely performed using these 5 surgical landmarks in straight forwards cases as well as in difficult cases. These landmarks can also assist in teaching young surgeons, in a step-wise manner, how to properly do round window electrode insertion in cochlear implantation surgery.

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Figures

Figure 1.
Figure 1.
View from the classical posterior tympanotomy (left side). AP, anterior postis; T, tegmen; PP, posterior postis; P, pyramid; SS, stapes superstructure.
Figure 2.
Figure 2.
After drilling the tegmen of the niche (left side). RWM, round window membrane; F, fustis; FN, facial nerve.
Figure 3.
Figure 3.
Blood vessels arborization on the inner wall of the scala tympani.
See this image and copyright information in PMC

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