Experience on Treating Variations of Facial Nerve in Cochlear Implant
with Endoscopic Assistant of Access to the Round Window
Objectives: Cochlear implant is the only solution of profound
sensorineural hearing loss. The round window implant provides minimal
injury to the inner ear, and may preserve the residual hearing, and the
key to insert the electrode array is to expose the round window, but
displaced facial nerve may hinder the visualization of the round window.
The aim of the study was to expose the round window and preserve the
full function of facial nerve with endoscopic assistant. Design: Cases
with variant facial nerve were observed with rigid endoscopy. The
locations of round window were assessed by endoscopy and we performed
retrofacial approach, or using “suspended” facial nerve technology to
expose the round window by shifting the facial nerve posteriorly.
Paticipants: Three cases were collected with variant facial nerve, two
cases performed retrofacial approach, one case performed “suspended”
facial nerve technology. Results: All cases inserted electrode array in
round window and preserve the residual hearing, and none of the cases
suffered facial nerve injury, chorda tympani nerve injury, misplacement
of the electrode array, and other complications. Conclusion: Rigid
endoscopy can provide a clear vision of round window, and assistant the
electric array insertion during cochlear implant surgery.