Soloperto Davide, De Cecco Francesca, Confuorto Gennaro, Dallari Virginia, Nocini Riccardo, Carner Marco, Sacchetto Luca
Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; Azienda Ospedaliera Universitaria Integrata Verona, Department of Surgery, Dentistry, Gynecology, and Pediatrics, Verona, Italy.
Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; Azienda Ospedaliera Universitaria Integrata Verona, Department of Surgery, Dentistry, Gynecology, and Pediatrics, Verona, Italy.
Am J Otolaryngol. 2024 Jan-Feb;45(1):104050. doi: 10.1016/j.amjoto.2023.104050. Epub 2023 Sep 16.
Cochlear implantation (CI) in children with malformed ears can be challenging through the standard surgical technique. Several alternative approaches have been described. The endoscopic-assisted approach can be chosen as an effective and safe surgical technique, overcoming the drawbacks of the traditional approach.
We further describe a combined technique based on a limited mastoidectomy with no posterior tympanotomy and an endoscopic transmeatal approach to the round window (RW): the electrode is driven from the mastoid to the middle ear through the attic.
The concomitant endoscopic assistance allows for improved surgical vision, reducing the risk of major complications. The main advantages of this technique are related to better visualization of the RW for safe insertion of the electrode; avoidance of damage to the facial nerve (FN), due to direct visualization, and sparing the posterior tympanotomy; avoidance of subtotal petrosectomy, if not necessary.
The purpose of this article, supported with a video file, is to describe step by step this endoscopic-assisted procedure in a patient with middle ear malformation.
对于耳部畸形的儿童，采用标准手术技术进行人工耳蜗植入（CI）可能具有挑战性。已经描述了几种替代方法。内镜辅助方法可作为一种有效且安全的手术技术被选用，克服了传统方法的缺点。
我们进一步描述一种基于有限乳突切除术且不进行后鼓室切开术以及经耳道内镜进入圆窗（RW）的联合技术：电极通过上鼓室从乳突驱动至中耳。
同时进行的内镜辅助可改善手术视野，降低主要并发症的风险。该技术的主要优点与以下方面有关：为安全插入电极更好地观察圆窗；由于直接观察避免对面神经（FN）造成损伤，并避免后鼓室切开术；如有必要，避免进行部分岩骨切除术。
本文的目的是结合视频文件逐步描述在一名中耳畸形患者中进行的这种内镜辅助手术。
