Clin Exp Otorhinolaryngol.  2016 Dec;9(4):314-318. 10.21053/ceo.2015.01739.

A New Surgical Approach for Direct Acoustic Cochlear Implant: A Temporal Bone Study

• Bruschini
• Forli F
• De Vito A
• Berrettini S

• KMID: 2360761
• DOI: http://doi.org/10.21053/ceo.2015.01739

Abstract

OBJECTIVES
The direct acoustic cochlear implant (DACI) is among the latest developments in the field of implantable acoustic prostheses. The surgical procedure requires a mastoidectomy and a posterior-inferior tympanotomy, with access to the facial recess at the level of the oval window, in a complex and lengthy surgical approach. Here, we report a new and considerably shorter surgical approach.
METHODS
The new approach involves positioning of artificial incus above the oval window through the superior-anterior tympanotomy. We performed DACI placement in temporal bone specimens (n=5) to assess the feasibility of the new approach.
RESULTS
The average time for the DACI implant in the temporal bones was only 112 minutes (range, 94 to 142 minutes) and there was little clinical risk associated with the procedure. Access was easy and drilling was minimal.
CONCLUSION
Our approach simplified the surgical procedure and consequently reduced the time required for DACI placement.

Keyword

Acoustics; CODACS; Tympanotomy; Prostheses and Implants

MeSH Terms

Acoustics*
Cochlear Implants*
Incus
Prostheses and Implants
Temporal Bone*

Figure

• 

  Fig. 1. The two surgical procedures. (A) Haeusler and Lenarz procedure: device in the mastoid with the artificial incus, through the posterior tympanotomy, orthogonal at the incus. (B) Our procedure: device in the mastoid with the artificial incus, through the anterior-superior tympanotomy, in place of the incus.

• 

  Fig. 2. The stapes and artificial incus seen through the external auditory canal. (A) The artificial incus is in the same position as the natural incus, over the stapes. (B) The artificial incus is in the same position as the natural incus, with the piston positioned (dotted circle).

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