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Common challenges in cochlear implant surgery performed under local anaesthesia and how to overcome them: the experience of UK surgeons

Published online by Cambridge University Press:  23 January 2023

R Abrar Open the ORCID record for R Abrar [Opens in a new window]  and
E Stapleton Open the ORCID record for E Stapleton [Opens in a new window]
R Abrar
Affiliation:
Department of Otolaryngology, Manchester Royal Infirmary, Manchester, UK
E Stapleton*
Affiliation:
Department of Otolaryngology, Manchester Royal Infirmary, Manchester, UK
*
Corresponding author: Emma Stapleton; Email: [email protected]
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Abstract

Background

Cochlear implantation performed under local anaesthesia is an increasingly accepted technique worldwide, though the literature to date includes only single-surgeon and single-centre experiences. This study explored the national experience of UK surgeons using this challenging surgical technique, with the goal of providing consensus recommendations.

Methods

A qualitative analysis was conducted of semi-structured interviews with 10 UK-based cochlear implantation surgeons, focusing on common challenges, how to overcome them and candidate selection.

Results

Cochlear implantation under local anaesthesia can potentially be offered to all eligible adult patients with favourable anatomy. A posterior tympanotomy and round window approach is recommended. Common challenges and recommendations are explored thematically: managing patient, surgeon and staff expectations; optimising communication; patient comfort and position; minimising pain and vertigo; and safe use of sedation.

Conclusion

This is the first study of national experience of cochlear implantation performed under local anaesthesia. Key themes, including refinements to surgical technique and optimising patient comfort and communication, have been explored in depth.

Keywords

Hearing losscochlear implantsanesthesia
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 11 , November 2023 , pp. 1289 - 1292
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Stapleton takes responsibility for the integrity of the content of the paper

This work was presented orally at the British Cochlear Implant Group 2021 Virtual Meeting, 22 December 2020, online, and presented orally (and awarded first prize for best oral presentation in the ‘Junior Doctor’ category) at the British Society of Otology Junior Free Papers Meeting, 30 June 2021, online.

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