Endoscopic Cochlear Implant: Literature Review and Current Status

Abstract

Purpose of Review

This study reviews current literatures on the use of rigid endoscopes for cochlear implant surgery.

Recent Findings

The indications for endoscopic use in otologic surgery are steadily increasing. It has been successfully used to treat middle ear disease such as chronic otitis media, cholesteatoma, ossiculoplasty, and stapes surgery. Endoscope technology and understanding of middle ear anatomy has improved over the last two decades. It has enabled magnified imaging of the middle ear including areas difficult to access with microscope. The anatomy of the round window niche has been very accurately defined. These advantages introduce a number of endoscopic approaches for more accurate electrode placement. In addition, it is believed that some of these new approaches are less invasive and reduce the risk of facial nerve injury from a posterior tympanotomy.

Summary

Endoscope enables excellent visualization of the middle ear with a clear ability to identify anomalies, precisely locate the round window, and perform a cochleostomy. Endoscopic-assisted cochlear implantation has been successfully performed for patients of all age groups and in patients with normal or abnormal middle and inner ears. The presence of a bony buttress appears to be an important factor in ensuring a successful outcome. Adequate experience with endoscopic ear surgery is necessary. It is possibly advantageous over conventional techniques in patients with abnormalities of the middle or inner ear. Long-term outcomes are required to fully assess the success of this procedure.

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