Pure endoscopic transcanal revision cochlear implantation for a misplaced electrode array: A novel and minimally invasive approach

OBJECTIVES

Misplacement of the CI electrode array is one of the rarest complications of cochlear implant surgery. This condition can be noticed intraoperatively and diagnosed radiologically in the early postoperative period. To present a novel and minimally invasive revision approach for a misplaced cochlear implant (CI) electrode array.

CASE

In this case report, the authors present a previously undescribed alternative minimally invasive revision cochlear implantation approach for a patient with a misplaced CI electrode array in the right ear who underwent bilateral simultaneous cochlear implantation one and a half years ago at another center.

CONCLUSION

To correct CI electrode array misplacement, the endoscopic transcanal approach is a safe and effective alternative to the conventional approach.

Cochlear implantation in Bjornstad syndrome: a case series with literature review

BACKGROUND

To report the presentation, diagnostic process, management and results of cochlear implantation of patients diagnosed with Bjornstad syndrome with profound sensorineural hearing loss (SNHL).

CASE PRESENTATION AND MANAGEMENT

A retrospective report of two siblings with Bjornstad syndrome suffering profound SNHL unresponsive to conventional hearing aids treated with bilateral simultaneous cochlear implantation.

SETTING

Tertiary-referral center.

RESULTS

Cochlear implant surgeries of two siblings (four ears) with profound SNHL and bilateral inner ear anomaly (incomplete partition type 1) were performed without complications. Postoperative audiometric measurements showed a significiant improvement in pure-tone threshold and a word recognition score. In the literature review, no previous case of Bjornstad syndrome treated with cochlear implantation has been reported.

CONCLUSIONS

Cochlear implantation is an effective, safe, and ultimate treatment option for Bjornstad syndrome with profound SNHL not responding to hearing aids.

A novel technique in treatment of advanced tympanosclerosis: results of malleus replacement and loop prostheses combination; pure endoscopic transcanal approach

PURPOSE

The objectives of the present clinical trial are to describe our surgical technique for advanced tympanosclerosis (TS) and to present the comparison of pre-and postoperative audiometric results.

METHODS

21 patients suffering from advanced TS (Only type III and IV patients according to Wielinga-Kerr classification) were enrolled in this prospective study. A pure transcanal endoscopic approach was preferred for all patients included in the study. Titanium malleus replacement prosthesis (MRP) and polytetrafluoroethylene (PTFE) loop prosthesis combination were used to bypass fixed ossicles to achieve sound transmission to the inner ear. Pre-and postoperative pure tone audiometry (PTA) measurements and air-bone gap (ABG) results compared, and surgical technique was considered successful if postoperative ABG was less than 20 dB.

RESULTS

Six of the 21 patients had been operated on before and the tympanic membrane (TM) was intact. The remaining 15 of the 21 patients were the primary cases, and TM perforation repair and ossiculoplasty using combination of the MRP and PTFE loop prosthesis were performed at single-staged operation. The average preoperative ABG values significantly improved from 37.1 ± 6.2 to 14.5 ± 1.2 dB postoperatively (p < 0.001). The mean preoperative air conduction threshold (ACT) significantly decreased from 51.7 ± 11.4 to 28.5 ± 9.1 dB (p < 0.001).

CONCLUSION

TS surgery is still a controversial issue particularly in stapes footplate fixation. However, our surgical and audiological results in this study are quite promising. The combination of titanium MRP and PTFE loop prosthesis for restoring sound transmission in advanced TS cases is reliable, effective and novel treatment option via endoscopic transcanal approach.