The suprameatal approach: an alternative surgical approach to cochlear implantation.

The suprameatal approach is an alternative method for performing cochlear implantation developed in the Sheba Medical Center in 1999. This technique eliminates the need for mastoidectomy and posterior tympanotomy. The middle ear is entered through a retroauricular tympanotomy flap, and the electrode is introduced into the cochlea via a tunnel drilled in the suprameatal region superior to Henle's spine. The suprameatal approach is a simple and safe technique that does not endanger the facial nerve nor the chorda tympani. A wide exposure of the promontory enables exact determination of scala tympani and smooth introduction of the electrodes into the cochlea. This technique may also be used in malformed or ossified cochlea. Until now 140 patients were operated in our department and an additional 48 patients were operated on in the department of Otorhinolaryngology at the University of Vienna employing the suprameatal approach technique.