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Transcanal infrapromontorial approach for internal auditory canal surgery and cochlear implantation

  • Otology
  • Published:
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Abstract

Objective

To demonstrate the feasibility of a transcanal infrapromontorial approach for vestibular schwannoma surgery through an anatomical dissection study and the description of a clinical case.

Methods

A microscopic and endoscopic dissection of cadaveric heads was undertaken through a transcanal infrapromontorial approach to the internal auditory canal (IAC), preserving the cochlea and the cochlear nerve. Description of the anatomy and surgical steps is reported as well as presentation of a clinical case in which a transcanal infrapromontorial approach was performed.

Results

In all of the cadaveric dissections, a transcanal infrapromontorial route with near total cochlea preservation was performed, removing only the most posterior portion of the basal turn of the cochlea. The IAC was opened through removal of “cochlear-vestibular bone”. At the end of the dissection a cochlear implant array was placed. A transcanal infrapromontorial approach was also performed in a patient to allow a concurrent cochlear implant placement, with good postoperative results.

Conclusion

The transcanal infrapromontorial approach permits the preservation of the cochlea and the cochlear nerve. This approach may be considered as an option in case of a small intracanalicular schwannoma removal (< 0.5 cm cerebellopontine angle spread), when concurrent cochlear implantation is indicated.

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Author information

Authors and Affiliations

  1. Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy

    Alessia Rubini, Luca Bianconi & Daniele Marchioni

  2. Kolling Deafness Research Centre, Macquarie University and University of Sydney, Sydney, NSW, Australia

    Alessia Rubini & Nirmal Patel

Authors
  1. Alessia Rubini
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  2. Luca Bianconi
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  3. Nirmal Patel
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  4. Daniele Marchioni
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Corresponding author

Correspondence to Alessia Rubini.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and the research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

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Rubini, A., Bianconi, L., Patel, N. et al. Transcanal infrapromontorial approach for internal auditory canal surgery and cochlear implantation. Eur Arch Otorhinolaryngol 277, 1053–1060 (2020). https://doi.org/10.1007/s00405-020-05821-2

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  • DOI: https://doi.org/10.1007/s00405-020-05821-2

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