The Surgery for multiple-electrode cochlear implantations

Abstract

Surgery for a multiple-electrode [human] cochlear implantation was described. This involves inserting the electrode array into the cochlea through the round window, or an opening drilled in the apical turn. The introduction of the electrode array into the cochlea is facilitated by specially-designed micro-claws and forceps. It is made easier through a posterior tympanotomy, but an anterior tympanotomy approach can be used. A small collar of Silastic sponge, adhering to the electrode, fits into the round window niche to reduce the chance of infection passing from the middle to the inner ear. Adequate room exists in a normal adult mastoid to seat the cochlear implant unit without producing a noticeable swelling. The implant is seated by performing a cortical mastoidectomy and cutting a bed in the mastoid part of the temporal bone. The unit is stabilized by seating it in a mold of medical grade Silastic. It is maintained in place with flaps constructed from subcutaneous, deep and temporalis fascia. The operation places the receiving coil at a convenient location for the application of the transmitting coil just behind the upper half of the pinna.