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Scala Tympani Cochleostomy II: Topography and Histology
Author(s) -
Adunka Oliver F.,
Radeloff Andreas,
Gstoettner Wolfgang K.,
Pillsbury Harold C.,
Buchman Craig A.
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e3181453a53
Subject(s) - medicine , round window , promontory , anatomy , cochlear implant , cochlear implantation , cochlea , temporal bone , annulus (botany) , modiolus (cochlea) , audiology , botany , archaeology , biology , history
Objective: To assess intracochlear trauma using two different round window‐related cochleostomy techniques in human temporal bones. Methods: Twenty‐eight human temporal bones were included in this study. In 21 specimens, cochleostomies were initiated inferior to the round window (RW) annulus. In seven bones, cochleostomies were drilled anterior‐inferior to the RW annulus. Limited cochlear implant electrode insertions were performed in 19 bones. In each specimen, promontory anatomy and cochleostomy drilling were photographically documented. Basal cochlear damage was assessed histologically and electrode insertion properties were documented in implanted bones. Results: All implanted specimens showed clear scala tympani electrode placements regardless of cochleostomy technique. All 21 inferior cochleostomies were atraumatic. Anterior‐inferior cochleostomies resulted in various degrees of intracochlear trauma in all seven bones. Conclusion: For atraumatic opening of the scala tympani using a cochleostomy approach, initiation of drilling should proceed from inferior to the round window annulus, with gradual progression toward the undersurface of the lumen. While cochleostomies initiated anterior‐inferior to the round window annulus resulted in scala tympani opening, many of these bones displayed varying degrees of intracochlear trauma that may result in hearing loss. When intracochlear drilling is avoided, the anterior bony margin of the cochleostomy remains a significant intracochlear impediment to in‐line electrode insertion.