Lesser Juan Carlos Cisneros, Brito Neto Rubens Vuono de, Martins Graziela de Souza Queiroz, Bento Ricardo Ferreira
Department of Otorhinolaryngology, Hospital das Clínicas, School of Medicine, Universidade de São Paulo, HC-FMUSP, São Paulo, SP, Brazil; Department of Otorhinolaryngology, Instituto Nacional de Rehabilitación, Mexico City, Mexico.
Department of Otorhinolaryngology, Hospital das Clínicas, School of Medicine, Universidade de São Paulo, HC-FMUSP, São Paulo, SP, Brazil.
Int Arch Otorhinolaryngol. 2017 Jan;21(1):102-108. doi: 10.1055/s-0036-1582266. Epub 2016 Apr 8.
Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. PubMed, MD consult and Ovid-SP databases. A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. The middle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated.
对于电极植入其他途径为禁忌的患者，中颅窝入路被认为是一种替代方法。尽管有关于通过中颅窝引入人工耳蜗可行性的颞骨研究，但到目前为止，很少有研究描述通过这种入路进行人工耳蜗手术的结果。本研究的目的是回顾一系列与通过中颅窝进行人工耳蜗植入相关的颞骨研究，以及不同手术组通过这种入路进行人工耳蜗植入后获得的结果。PubMed、MD consult和Ovid-SP数据库。共有8项人类尸体颞骨研究和6项报告通过中颅窝入路进行人工耳蜗手术的研究符合纳入标准。颞骨研究表明，通过该途径进行人工耳蜗植入是可行的。到目前为止，只有两个手术组通过中颅窝进行了人工耳蜗植入，共有15例植入患者。一组在蜗底最上部进入耳蜗，沿中回和顶回方向插入植入物；同时，另一组以逆行方式向中回和蜗底方向在顶回插入植入物。两组获得的结果相似。当电极植入的其他途径为禁忌时，中颅窝入路是人工耳蜗植入的一种良好替代方法。
