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Minimally Invasive Cochlear Implant Surgery


Cochlear implantation has become a common method of rehabilitating severely to profoundly deaf children and adults. Standard cochlear implantation requires an extended postauricular and scalp incision and large flap, mastoidectomy, facial recess approach, cochleostomy, and insertion of an electrode into the scala tympani. The most common complications associated with the standard approach to cochlear implantation include flap breakdown and electrode misplacement.

Limited data concerning minimally invasive techniques have been described in the literature. Generally, such techniques involve a less-extensive incision and less-invasive manner of securing the receiver/stimulator onto the skull or, more recently, the use of image-guided navigation for percutaneous drilling from the surface of the mastoid directly to the cochlea.

In recent years, the standard approach to cochlear implantation with a large incision has been challenged by successful implantation of cochlear implants in numerous patients with a much smaller incision and a less-invasive approach. In addition, CT-guided preoperative planning of the drilling path and intraoperative CT guidance appear promising, which could further reduce the invasiveness of the procedure. However, this technique remains to be proven as comparable in safety and efficacy as the established minimally invasive techniques in Technique.

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