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Cochlear implant electrode array misplacement: a cautionary case report

Published online by Cambridge University Press:  01 February 2012

E Muzzi ,
P Boscolo-Rizzo ,
R Santarelli  and
M A Beltrame
E Muzzi*
Affiliation:
Audiology and Phoniatrics Service, University of Padua School of Medicine, Treviso Regional Hospital, Italy Otorhinolaryngology Unit, Department of Surgical Specialties, Santa Maria della Misericordia University Hospital, Udine, Italy
P Boscolo-Rizzo
Affiliation:
Otolaryngology Section, Department of Medical and Surgical Specialties, University of Padua School of Medicine, Treviso Regional Hospital, Italy
R Santarelli
Affiliation:
Audiology and Phoniatrics Service, University of Padua School of Medicine, Treviso Regional Hospital, Italy
M A Beltrame
Affiliation:
Division of Otorhinolaryngology, Santa Maria del Carmine Hospital, Rovereto, Trento, Italy
*
Address for correspondence: Dr Enrico Muzzi, Audiology and Phoniatrics Service, Department of Medical and Surgical Specialties, University of Padua School of Medicine, Treviso Regional Hospital, Piazza Ospedale, 1-31100 Treviso, Italy Fax: +39 0422 322351 E-mail: [email protected]
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Abstract

Objective:

To report a series of pitfalls and complications in a case of cochlear implantation.

Method:

Case report.

Results:

An 11-year-old boy affected by auditory neuropathy underwent cochlear implantation. Intra-operative assessment was apparently consistent with correct insertion of the electrode array into the cochlea. However, subsequent high resolution computed tomography revealed that the entire electrode array was curled up within the vestibule. Revision surgery was complicated by cerebrospinal fluid leakage. A straight probe was repeatedly inserted into the internal auditory canal, before conversion to a canal wall down procedure and appropriate positioning of the electrode array.

Conclusion:

In this case, mild anteriorisation of the facial nerve created an awkward insertion angle for the electrode array via the retro-facial route, which may have triggered the described series of adverse events.

Keywords

Cochlear ImplantationFacial NerveComplications
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 414 - 417
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Jain, R, Mukherji, SK. Cochlear implant failure: imaging evaluation of the electrode course. Clin Radiol 2003;58:288–93CrossRefGoogle ScholarPubMed
2Runge-Samuelson, CL, Drake, S, Wackym, PA. Quantitative analysis of electrically evoked auditory brainstem responses in implanted children with auditory neuropathy/dyssynchrony. Otol Neurotol 2008;29:174–8CrossRefGoogle ScholarPubMed
3Roland, JT Jr.A model for cochlear implant electrode insertion and force evaluation: results with a new electrode design and insertion technique. Laryngoscope 2005;115:1325–39CrossRefGoogle Scholar
4Tange, RA, Grolman, W, Maat, A. Intracochlear misdirected implantation of a cochlear implant. Acta Otolaryngol 2006;126:650–2CrossRefGoogle ScholarPubMed
5Copeland, BJ, Pillsbury, HC, Buchman, CA. Prospective evaluation of intraoperative cochlear implant radiographs. Otol Neurotol 2004;25:295–7CrossRefGoogle ScholarPubMed
6Pau, H, Parker, A, Sanli, H, Gibson, WP. Displacement of electrodes of a cochlear implant into the vestibular system: intra- and postoperative electrophysiological analyses. Acta Otolaryngol 2005;125:1116–18CrossRefGoogle ScholarPubMed
7Beltrame, MA, Frau, GN, Shanks, M, Robinson, P, Anderson, I. Double posterior labyrinthotomy technique: results in three Med-El patients with common cavity. Otol Neurotol 2005;26:177–82CrossRefGoogle ScholarPubMed
8Huang, CC, Lin, CY, Wu, JL. Retrofacial approach of cochlear implantation in inner ear malformation with aberrant facial nerve: a case report. Auris Nasus Larynx 2006;33:179–82CrossRefGoogle ScholarPubMed
9Mecca, MA, Wagle, W, Lupinetti, A, Parnes, S. Complication of cochlear implantation surgery. AJNR Am J Neuroradiol 2003;24:2089–91Google ScholarPubMed
10Ramalingam, R, Ramalingam, KK, Padmaja, HS. An unusual occurrence in cochlear implantation surgery: misplaced electrode. J Laryngol Otol 2009;123:e4CrossRefGoogle ScholarPubMed
11Sorrentino, T, Coté, M, Eter, E, Laborde, ML, Cochard, N, Deguine, O et al. Cochlear reimplantations: technical and surgical failures. Acta Otolaryngol 2009;129:380–4CrossRefGoogle ScholarPubMed