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PAPER (ENG) - The Safety of FEESST - An Analysis of 500 Consecutive Evaluations
PAPER (ENG) - The Safety of FEESST - An Analysis of 500 Consecutive Evaluations
PAPER (ENG) - The Safety of FEESST - An Analysis of 500 Consecutive Evaluations
discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/12707615
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6 authors, including:
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International Journal of Pediatric Otorhinolaryngology (2006) 70, 591596
www.elsevier.com/locate/ijporl
KEYWORDS Summary
Cochlear implant;
Cochleovestibular Objective: To devise a safe and effective method of optimal customized electrode
malformation; placement in the common cavity of children with cochleovestibular malformations.
Common cavity; Methods: Specialized electrodes were manufactured on the basis of three-dimen-
Custom-made cochlear sional data obtained from the high resolution computed tomography (HRCT) scans of
implant electrode; the temporal bones of these two children. Electrode positioning was achieved with
Direct electrode direct endoscopic view of the cavity utilizing a three-hole common cavity technique.
positioning Results: Optimal electrode positioning in apposition to the medial neuroepithelium in
the common cavity was verified visually intraoperatively. Postoperatively, minimal
stable electrical current levels were found to be required.
Conclusions: Custom-designed electrodes have the potential to offer improved
results in children with common cavity malformations. Intraoperative direct position-
ing may further improve these results.
# 2005 Published by Elsevier Ireland Ltd.
Fig. 3 Parasagittal T2 weighted MRI image through the Fig. 5 Axial T2 weighted MRI image displaying a common
internal auditory canal in our first patient shows presence cavity on the left and a common cavity with a fraction of a
of cochleovestibular nerve, albeit of diminished diameter. basal turn of the cochlea on the right.
hearing loss by behavioral audiometry at age 15 poral bones revealed a common cavity malformation
months. Profound bilateral sensorineural hearing on the right with a severely hypoplastic IAC, while
loss was confirmed with auditory steady state the left had a lesser degree of malformation with a
evoked potentials that revealed absent thresholds dilated internal auditory canal (Fig. 6). MR of the
on the right and thresholds present in the lower temporal bones corroborated these findings showing
frequencies at 125 db. Routine serologic screening, a severely hypoplastic IAC with absent cochlear
Connexin-26 testing and medical genetics evalua-
tion disclosed no abnormalities. A HRCT of the tem-
3. Discussion
Fig. 8 Endoscopic view of the common cavity during
electrode positioning. Electrode base pairs can be seen There are 20 reported cases of common cavity
abutting the neuroepithelium on the medial aspect of the implantation in the literature [12]. These patients
common cavity. Top part of the photograph is superior; continue to present a challenge for cochlear
bottom part of the photograph is inferior. implantation. Evaluation by MR imaging in such
Endoscopically guided placement of prefabricated cochlear implant electrodes 595
children is essential to rule out aplasia of the elements of the malformed cochlea under endo-
auditory nerve. Oblique sagital images, perpendi- scopic guidance is possible and may offer an addi-
cular to the IAC may provide the best cross sec- tional advantage.
tional views for determination of the presence and
degree of malformation of the cochlear nerve [13].
In these cases auditory brainstem response (ABR)
testing were not adequate in providing information
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