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Endoscopic Cochlear Implant: Literature Review and Current Status

  • Otology (E Truy, Section Editor)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This study reviews current literatures on the use of rigid endoscopes for cochlear implant surgery.

Recent Findings

The indications for endoscopic use in otologic surgery are steadily increasing. It has been successfully used to treat middle ear disease such as chronic otitis media, cholesteatoma, ossiculoplasty, and stapes surgery. Endoscope technology and understanding of middle ear anatomy has improved over the last two decades. It has enabled magnified imaging of the middle ear including areas difficult to access with microscope. The anatomy of the round window niche has been very accurately defined. These advantages introduce a number of endoscopic approaches for more accurate electrode placement. In addition, it is believed that some of these new approaches are less invasive and reduce the risk of facial nerve injury from a posterior tympanotomy.

Summary

Endoscope enables excellent visualization of the middle ear with a clear ability to identify anomalies, precisely locate the round window, and perform a cochleostomy. Endoscopic-assisted cochlear implantation has been successfully performed for patients of all age groups and in patients with normal or abnormal middle and inner ears. The presence of a bony buttress appears to be an important factor in ensuring a successful outcome. Adequate experience with endoscopic ear surgery is necessary. It is possibly advantageous over conventional techniques in patients with abnormalities of the middle or inner ear. Long-term outcomes are required to fully assess the success of this procedure.

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References

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  1. Govindaraj S, Adappa ND, Kennedy DW. Endoscopic sinus surgery: evolution and technical innovations. J Laryngol Otol. 2010;124(3):242–50.

    Article  CAS  PubMed  Google Scholar 

  2. Mer SB, Derbyshire AJ, Brushenko A, Pontarelli DA. Fiberoptic endotoscopes for examining the middle ear. Arch Otolaryngol. 1967;85(4):387–93.

    Article  CAS  PubMed  Google Scholar 

  3. Poe DS, Rebeiz EE, Pankratov MM, Shapshay SM. Transtympanic endoscopy of the middle ear. Laryngoscope. 1992;102(9):993–6.

    Article  CAS  PubMed  Google Scholar 

  4. Balkany T. Endoscopy of the cochlea during cochlear implantation. Ann Otol Rhinol Laryngol. 1990;99(11):919–22.

    Article  CAS  PubMed  Google Scholar 

  5. Tarabichi M. Endoscopic management of acquired cholesteatoma. Am J Otol. 1997;18(5):544–9.

    CAS  PubMed  Google Scholar 

  6. Tarabichi M. Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol. 1999;108(1):39–46.

    Article  CAS  PubMed  Google Scholar 

  7. Tarabichi M. Endoscopic management of cholesteatoma: long-term results. Otolaryngol Head Neck Surg. 2000;122(6):874–81.

    Article  CAS  PubMed  Google Scholar 

  8. Tarabichi M. Transcanal endoscopic management of cholesteatoma. Otol Neurotol. 2010;31(4):580–8.

    PubMed  Google Scholar 

  9. Leite J, Lobo R, Cabral T, Nogueira JF. Endoscopic Cochlear Implant: A Series of Cases. Otolaryngol Head and Neck Surg. 2014;151(1_suppl):P84.

    Article  Google Scholar 

  10. Al-hajeri M. P084: Endoscopic Cochlear implantation: a new procedure. Otolaryngol Head Neck Surg. 2007;137(2 suppl):P240.

    Article  Google Scholar 

  11. Marchioni D, Grammatica A, Alicandri-Ciufelli M, Genovese E, Presutti L. Endoscopic cochlear implant procedure. Eur Arch Otorhinolaryngol. 2014;271(5):959–66.

    Article  PubMed  Google Scholar 

  12. Dia A, Nogueira JF, O’Grady KM, Redleaf M. Report of endoscopic cochlear implantation. Otol Neurotol. 2014;35(10):1755–8.

    Article  PubMed  Google Scholar 

  13. • Marchioni D, Soloperto D, Guarnaccia MC, Genovese E, Alicandri-Ciufelli M, Presutti L. Endoscopic assisted cochlear implants in ear malformations. Eur Arch Otorhinolaryngol. 2015;272(10):2643–52. Highlights the usefulness of the endoscope for cochlear implantation in ear malformations.

    Article  PubMed  Google Scholar 

  14. • Migirov L, Shapira Y, Wolf M. The feasibility of endoscopic transcanal approach for insertion of various cochlear electrodes: a pilot study. Eur Arch Otorhinolaryngol. 2015;272(7):1637–41. States importance of a good knowledge of endoscopic anatomy and techniques for safe surgery and minimal complications.

    Article  PubMed  Google Scholar 

  15. Orhan KS, Polat B, Çelik M, Çomoğlu Ş, Güldiken Y. Endoscopic-assisted cochlear implantation: a case series. J Int Adv Otol. 2016;12(3):337–40.

    Article  PubMed  Google Scholar 

  16. • Marchioni D, Soloperto D, Bianconi L, Guarnaccia MC, Genovese E, Presutti L. Endoscopic approach for cochlear implantation in advanced otosclerosis: A case report. Auris Nasus Larynx. 2016;43(5):584–90. Describes how the endoscope provides better imaging and enables accurate placement of electrodes in advanced otosclerosis.

    Article  PubMed  Google Scholar 

  17. • Marchioni D, Carner M, Soloperto D, Sacchetto A, Genovese E, Presutti L. Endoscopic-assisted cochlear implant procedure in CHARGE syndrome: Preliminary report. Acta Otolaryngol Case Rep. 2017;2(1):52–8. The only paper which provides audiological outcomes of endoscopic cochlear implantation and also supports the use of endoscopes in malformed ears.

    Article  Google Scholar 

  18. Kronenberg J, Migirov L, Dagan T. Suprameatal approach: new surgical approach for cochlear implantation. J Laryngol Otol. 2001;115(4):283–5.

    Article  CAS  PubMed  Google Scholar 

  19. Kronenberg J, Baumgartner W, Migirov L, Dagan T, Hildesheimer M. The suprameatal approach: an alternative surgical approach to cochlear implantation. Otol Neurotol. 2004;25(1):41–5.

    Article  PubMed  Google Scholar 

  20. Postelmans JT, Tange RA, Stokroos RJ, Grolman W. The suprameatal approach: a safe alternative surgical technique for cochlear implantation. Otol Neurotol. 2010;31(2):196–203.

    Article  PubMed  Google Scholar 

  21. Kiratzidis T, Arnold W, Iliades T. Veria operation updated. ORL. 2002;64(6):406–12.

    Article  PubMed  Google Scholar 

  22. Kiratzidis T. 'Veria operation: cochlear implantation without a mastoidectomy and a posterior tympanotomy. InUpdates in Cochlear Implantation 2000 (vol 57, pp 127-130). Karger Publishers, Basel.

  23. Colletti V, Fiorino FG, Carner M, Pacini L. Basal turn cochleostomy via the middle fossa route for cochlear implant insertion. Otol Neurotol. 1998;19(6):778–84.

    CAS  Google Scholar 

  24. Colletti V, Fiorino FG, Carner M, Sacchetto L, Giarbini N. New approach for cochlear implantation: cochleostomy through the middle fossa. Otolaryngol Head Neck Surg. 2000;123(4):467–74.

    Article  CAS  PubMed  Google Scholar 

  25. Lesser JC, de Brito Neto RV, Martins GD, Bento RF. Cochlear implantation through the middle fossa approach: a review of related temporal bone studies and reported cases. Int Arch Otorhinolaryngol. 2017;21(01):102–8.

    PubMed  Google Scholar 

  26. Fayad JN, Wanna GB, Micheletto JN, Parisier SC. Facial nerve paralysis following cochlear implant surgery. Laryngoscope. 2003;113(8):1344–6.

    Article  PubMed  Google Scholar 

  27. Hamamoto M, Murakami G, Kataura A. Topographical relationships among the facial nerve, chorda tympani nerve and round window with special reference to the approach route for cochlear implant surgery. Clin Anat. 2000;13(4):251–6.

    Article  CAS  PubMed  Google Scholar 

  28. Calli C, Pinar E, Oncel S, Tatar B, Tuncbilek MA. Measurements of the facial recess anatomy: implications for sparing the facial nerve and chorda tympani during posterior tympanotomy. Ear, Nose & Throat J. 2010;89(0):490.

    Google Scholar 

  29. Roland PS, Wright CG, Isaacson B. Cochlear implant electrode insertion: the round window revisited. Laryngoscope. 2007;117(8):1397–402.

    Article  PubMed  Google Scholar 

  30. Kennedy DW. Technical innovations and the evolution of endoscopic sinus surgery. Ann Otol Rhinol Laryngol. 2006;115(9_suppl):3–12.

    Article  Google Scholar 

  31. Hershcovitch M, Samy RN, Nistor V. Endoscopic Cochlear Implantation: A Prospective Study. Otolaryngol Head Neck Surg. 2012;147(2_suppl):P86.

    Article  Google Scholar 

  32. Jeppesen J, Faber CE. Surgical complications following cochlear implantation in adults based on a proposed reporting consensus. Acta Otolaryngol. 2013;133(10):1012–21.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Raghunandhan S, Kameswaran M, Kumar RA, Agarwal AK, Hossain MD. A study of complications and morbidity profile in cochlear implantation: the MERF experience. Indian J Otolaryngol Head Neck Surg. 2014;66(1):161–8.

    Article  CAS  PubMed  Google Scholar 

  34. Bhatia K, Gibbin KP, Nikolopoulos TP, O'donoghue GM. Surgical complications and their management in a series of 300 consecutive pediatric cochlear implantations. Otol Neurotol. 2004;25(5):730–9.

    Article  PubMed  Google Scholar 

  35. Sunde J, Webb JB, Moore PC, Gluth MB, Dornhoffer JL. Cochlear implant failure, revision, and reimplantation. Otol Neurotol. 2013;34(9):1670–4.

    Article  PubMed  Google Scholar 

  36. Tarkan Ö, Tuncer Ü, Özdemir S, Sürmelioğlu Ö, Çetik F, Kıroğlu M, et al. Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations. Int J Pediatr Otorhinolaryngol. 2013;77(4):473–9.

    Article  PubMed  Google Scholar 

  37. Farinetti A, Gharbia DB, Mancini J, Roman S, Nicollas R, Triglia JM. Cochlear implant complications in 403 patients: Comparative study of adults and children and review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131(3):177–82.

    Article  CAS  PubMed  Google Scholar 

  38. •• Tarabichi M, Nazhat O, Kassouma J, Najmi M. Endoscopic cochlear implantation: Call for caution. Laryngoscope. 2016;126(3):689–92. Calls for caution with Endoscopic Cochlear Implantation based on Radiologic Studies and Personal Experience.

    Article  PubMed  Google Scholar 

  39. Philip R, Prepageran N. Endoscopic ear surgery—the future of otologic surgery. Odisha J Otorhinolaryngol Head Neck Surg. 2016;X(1):6–8.

    Google Scholar 

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Acknowledgements

Director-General of Health Malaysia for permission to publish this review.

Author information

Authors and Affiliations

  1. Otorhinolaryngology Department, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia

    Philip Rajan & Hui Mon Teh

  2. Otorhinolaryngology Department, Universiti Malaya, Kuala Lumpur, Malaysia

    Narayanan Prepageran

  3. Otorhinolaryngology Department, Hospital Sultan Ismail, Johor, Malaysia

    Tengku Izam Tengku Kamalden

  4. Otorhinolaryngology Department, Universiti Malaysia Sarawak, Sarawak, Malaysia

    Ing Ping Tang

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  1. Philip Rajan
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Correspondence to Philip Rajan.

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This article is part of the Topical Collection on Otology

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Rajan, P., Teh, H.M., Prepageran, N. et al. Endoscopic Cochlear Implant: Literature Review and Current Status. Curr Otorhinolaryngol Rep 5, 268–274 (2017). https://doi.org/10.1007/s40136-017-0164-2

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