Active and Adequate Exposure of the Facial Nerve and Chorda Tympani Nerve to Improve the Safety of Cochlear Implantation.

Ling Lu,Xiaoyun Qian,Chuanyao Lin,Jianfei Dong,Xia Gao,Chenjie Yu,Maohua Wang

doi:10.1177/0145561319874014

Abstract

The posterior tympanum approach of cochlear implantation is easy to damage the facial nerve and cord tympanic nerve. Therefore, we need to improve the safety of cochlear implantation. To discuss the safety and feasibility of active and adequate transparent exposure of the facial nerve and chorda tympani nerve during the surgery. A retrospective analysis was performed on all 945 patients who underwent cochlear implantation from January 2011 to September 2017. All patients have been followed up for 14 months to 5 years postoperatively and postoperative complications have been observed. All 945 patients received artificial cochlear implantation. The facial nerves of 76 cases were above the horizontal semicircular canal plane, while narrow facial recess was observed in 44 cases. Serious chorda tympani nerve variation was found in 1 case. No facial paralysis and facial nerve irritation and abnormal taste occurred after operation. Cochlear implantation with initiative and adequate exposure of facial nerve and the chorda tympani nerve can improve the safety of the cochlear implant surgery. Our study provide a safe and effective method for clinical cochlear implantation to reduce facial nerve and tympanic cord nerve injury.

Highlights

By 2015, there has been over 300 thousand deafness patients who received cochlear implantation around the world.[1]
All 945 patients have the facial recess opened and implanted electrodes successfully after exposing the facial nerve and chorda tympani nerve actively and adequately, and all the patient’s facial nerve and chorda tympani nerve were kept intact during operation
We found 76 cases of high facial nerve, which was higher than the plane of horizontal semicircular canal (Figure 2), 44 cases of facial nerve preposition, facial recess stenosis which was less than 2 mm (Figure 3), and 1 case of serious chorda tympani nerve variation, which lies transverse above half of the facial recess (Figure 4)

Summary

Introduction

By 2015, there has been over 300 thousand deafness patients who received cochlear implantation around the world.[1]. We proposed an operation method of exposed facial nerve and chorda tympani nerve actively and adequately, in other words, exposed facial recess extremely, safely, and efficiently, so as to provide guarantee for implanting electrodes smoothly, and reduced the incidence of facial paralysis, taste abnormalities, and other surgical complications at the same time. Conclusions: Cochlear implantation with initiative and adequate exposure of facial nerve and the chorda tympani nerve can improve the safety of the cochlear implant surgery. Our study provide a safe and effective method for clinical cochlear implantation to reduce facial nerve and tympanic cord nerve injury

Objectives

Methods

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Conclusion