cochlear implant candidacy

cochlear implant surgery

what to expect after cochlear implant surgery

bilateral cochlear implants

the cochlear implant program

legislation and advocacy for cochlear implants


slide presentation: a brief overview of pediatric cochlear implants

FOX news coverage of Bill 3855 - insurance coverage for pediatric cochlear implant services

cochlear implant surgery - Advanced Bionics Helix electrode off-stylet insertion technique

Cochlear implant surgery for young infants (ages 9 months and older) and children take approximately one to two hours and is done in an outpatient setting, and occasionally, only an overnight stay is required. Pediatric CI surgery is usually less complicated than adult CI surgery due to the smaller incisions, no need for hair shaving, smaller mastoid cavity, and more straightforward access to the cochlea. A cochlear abnormality, such as a Mondini malformation, severe cochlear hypoplasia, or large vestibular aqueduct can increase the complexity of the case.

For both pediatric and adult cochlear implants, a mastoidectomy is required to access the facial recess (posterior tympanotomy approach). This opening gives the surgeon access to the round window and cochlea. A tiny opening, called a cochleostomy, is made into the scala tympani of the cochlea. The multichannel electrode, shown here, is fully inserted using a gentle, off-stylet technique.

Above: Sagittal view X-ray of the skull showing a right-sided cochlear implant.

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Pediatric cochlear implant surgery - right ear - off-stylet technique using the Advanced Bionics Helix electrode system

  1. Right cortical mastoidectomy
  2. Widening of the antrum and exposure of the incus
  3. Thinning of the bony posterior external auditory canal
  4. Identification and opening of the facial recess - the landmarks are the chorda tympani nerve, incus buttress, and the vertical segment of the facial nerve
  5. Exposure of the incudostapedial joint, cochlear, and round window niche
  6. Creation of the cochleostomy anterior and inferior to the round window niche in order to enter the scala tympani and avoid injury to the basilar membrane
  7. Healon is instilled into scala tympani
  8. Gentle insertion of the electrode into the scala tympani
  9. Careful sealing of the cochleostomy around the hub of the electrode with fascia

cochlear implant surgery video - advanced bionics

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