Since its clinical introduction 40 years ago, cochlear implantation surgery has continued
to evolve. Although the standard mastoidectomy with posterior tympanotomy has not
changed, recent refinements have focused on minimal incisions and implantation techniques
designed to preserve hearing. Evidence shows that smaller incisions with modest manipulation
of soft tissue do not affect postoperative healing outcomes. There has been a trend
advocating “soft surgical” techniques in an attempt to preserve the cochlear sensory
epithelium. However, the literature is inconclusive as to the outcomes of “soft surgical”
over standard techniques for hearing preservation, including round window insertion
and the use of adjuvants with insertion. Cochlear implantation remains an important
therapeutic option for hearing loss, with new techniques and implant designs offering
prospects for better outcomes using less invasive techniques.
Keywords
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Referenecs
- Worldwide trends in bilateral cochlear implantation.Laryngoscope. 2010; 120 (suppl 2): S17-S44
- Spectrum of immune-mediated inner ear disease and cochlear implant results.Laryngoscope. 2012; 122: 2557-2562
- Cochlear implantation in patients with neurofibromatosis type 2 and bilateral vestibular schwannoma.Otol Neurotol. 2006; 27: 512-518
- Cochlear implantation as a durable tinnitus treatment in single-sided deafness.Cochlear Implants Int. 2011; 12 (suppl 1): S26-S29
- Consumer satisfaction is not enough: Hearing aids are still about hearing.Semin Hear. 1997; 18: 11
- Programmatic challenges in obtaining and confirming the pneumococcal vaccination status of cochlear implant recipients.Otol Neurotol. 2010; 31: 1334-1336
- Spoken language development in children following cochlear implantation.J Am Med Assoc. 2010; 303: 1498-1506
- Cochlear implant rehabilitation in older adults: Literature review and proposal of a conceptual framework.J Am Geriatr Soc. 2012; 60: 1936-1945
- Cochlear implantation: Relationships with research on auditory deprivation and acclimatization.Ear Hear. 1996; 17: 38S-50S
- Preoperative temporal bone computed tomography scan and its use in evaluating the pediatric cochlear implant candidate.Laryngoscope. 1997; 107: 1100-1106
- Accuracy of high-resolution computed tomography in cochlear implantation.Otolaryngol Head Neck Surg. 1996; 114: 38-43
- Computed tomography: How accurate a predictor for cochlear implantation?.Laryngoscope. 1990; 100: 687-692
- High-resolution computed tomography in evaluation of cochlear patency in implant candidates: A comparison with surgical findings.J Laryngol Otol. 1994; 108: 743-748
- Cochlear implant candidates: Assessment with CT and MR imaging.Radiology. 1987; 164: 53-57
- Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle.Am J Neuroradiol. 1993; 14: 47-57
- MRI versus CT in assessment of cochlear patency in cochlear implant candidates.Acta Otolaryngol. 2004; 124: 577-581
- Imaging findings of cochlear nerve deficiency.Am J Neuroradiol. 2002; 23: 635-643
- Clinical application of magnetic resonance imaging in 30 cochlear implant patients.Otol Neurotol. 2001; 22: 818-822
- Magnetic resonance imaging at 1.5 T after cochlear implantation.Otol Neurotol. 2010; 31: 1215-1220
American Speech-Language-Hearing Association: Cochlear implants [Technical Report], 2004. Available at: www.asha.org/policy. Accessed December 11, 2013.
Centers for Medicare and Medicaid Services: Cochlear implantation, 2012. Available at: http://www.cms.gov/Medicare/Coverage/Coverage-with-Evidence-Development/Cochlear-Implantation-.html. Accessed December 9, 2013.
- Cochlear implantation in older adults.Medicine (Baltimore). 2012; 91: 229-241
- Congenital malformations of the inner ear: A classification based on embryogenesis.Laryngoscope. 1987; 97: 2-14
- Cochlear neuronal populations in developmental defects of the inner ear. Implications for cochlear implantation.Acta Otolaryngol. 1985; 99: 14-20
- Update on bilateral cochlear implantation.Curr Opin Otolaryngol Head Neck Surg. 2003; 11: 388-393
- Simultaneous bilateral cochlear implantation in adults: A multicenter clinical study.Ear Hear. 2006; 27: 714-731
- Bilateral versus unilateral cochlear implants in children: A study of spoken language outcomes.Ear Hear. 2014; 35: 396-409
- Estimates of the cost-effectiveness of pediatric bilateral cochlear implantation.Ear Hear. 2010; 31: 611-624
- What is the optimal timing for bilateral cochlear implantation in children?.Cochlear Implants Int. 2011; 12 (suppl 2): S8-S14
- Surgical factors in pediatric cochlear implantation and their early effects on electrode activation and functional outcomes.Otol Neurotol. 2008; 29: 502-508
- Surgical techniques in cochlear implants.Otolaryngol Clin North Am. 2012; 45: 69-80
- Minimal access and standard cochlear implantation: A comparative study.Int J Pediatr Otorhinolaryngol. 2012; 76: 1102-1106
- Temporal Bone Dissection Guide. (ed 2). Thieme Medical Publishers, Inc, New York, NY2011
- Preservation of basal inner ear structures in cochlear implantation.ORL J Otorhinolaryngol Relat Spec. 2004; 66: 306-312
- Anatomy of the round window niche.Ann Otol Rhinol Laryngol. 1986; 95: 444-446
Balkany TJ, Brown KD, Ganz BJ: Cochlear implantation. In: Flint PW, Haughey BH, Lund, VJ, editors. Cummings Otolaryngology Head & Neck Surgery. ed 5. Philadelphia: Mosby Elsevier, p. 2234-2242, 2010
- Soft cochlear implantation: Rationale for the surgical approach.Trends Amplif. 2009; 13: 124-138
- Cochlear implant electrode insertion: The round window revisited.Laryngoscope. 2007; 117: 1397-1402
- Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes.Laryngoscope Volume 124; Supplement 6; S1-7. 2014;
- Hearing preservation surgery: Cochleostomy or round window approach? A systematic review.Otol Neurotol. 2013; 34: 667-674
- Comparison of cochlear implant performance after round window electrode insertion compared with traditional cochleostomy.Otolaryngol Head Neck Surg. 2013; 148: 822-826
- New Clarion electrode with positioner: Insertion studies.Ann Otol Rhinol Laryngol Suppl. 2000; 185: 16-18
- Effects of communication mode on skills of long-term cochlear implant users.Ann Otol Rhinol Laryngol Suppl. 2000; 185: 89-92
- Impact of the insertion speed of cochlear implant electrodes on the insertion forces.Otol Neurotol. 2011; 32: 565-570
- The effects of insertion speed on inner ear function during cochlear implantation: A comparison study.Audiol Neurootol. 2013; 18: 17-22
- Fixation of the electrode cable during cochlear implantation: The split bridge technique.Laryngoscope. 1995; 105: 217-218
- Intracranial complications of cochlear implantation.Otol Neurotol. 2007; 28: 459-462
- Cochlear implant fixation and dura exposure.Otol Neurotol. 2010; 31: 1211-1214
- The temporalis pocket technique for cochlear implantation: An anatomic and clinical study.Otol Neurotol. 2009; 30: 903-907
- Soft tissue complications after small incision pediatric cochlear implantation.Laryngoscope. 2009; 119: 980-983
- Residual speech recognition and cochlear implant performance: Effects of implantation criteria.Am J Otol. 1999; 20: 445-452
- Prelingually deafened children׳s performance with the nucleus multichannel cochlear implant.Am J Otol. 1993; 14: 437-445
- Medical or surgical complications related to the Nucleus multichannel cochlear implant.Ann Otol Rhinol Laryngol Suppl. 1988; 135: 8-13
- Surgical complications with the cochlear multiple-channel intracochlear implant: Experience at Hannover and Melbourne.Ann Otol Rhinol Laryngol. 1991; 100: 131-136
- Surgical pitfalls in cochlear implantation.Laryngoscope. 1993; 103: 741-744
- Revision cochlear implant surgery in children: The Johns Hopkins experience.Otol Neurotol. 2010; 31: 74-82
- Revision cochlear implantation surgery in adults: Indications and results.Otol Neurotol. 2008; 29: 639-648
- Effect of experimentally induced otitis media on cochlear implants.Ann Otol Rhinol Laryngol. 1987; 96: 174-177
- Bacterial biofilms may contribute to persistent cochlear implant infection.Otol Neurotol. 2004; 25: 953-957
- Risk of bacterial meningitis in children with cochlear implants.N Engl J Med. 2003; 349: 435-445
- Does meningitis after cochlear implantation remain a concern in 2011?.Otol Neurotol. 2012; 33: 93-95
- Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among children aged 6-18 years with immunocompromising conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP).MMWR Morb Mortal Wkly Rep. 2013; 62: 521-524
- Assessing the immunization status of pediatric cochlear implant recipients using a state-maintained immunization registry.Otolaryngol Head Neck Surg. 2010; 143: 487-491
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Publication history
Published online: September 18, 2014
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© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
