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[재등록 1074] Cochlear implantation

Prof. Jawon Koo Seoul National University Bundang Hospital | Republic of Korea Speciality : Otorhinolaryngology

20:25

Information

Related Information
A cochlear implant is a surgically implanted neuroprosthetic device that provides a sense of sound to a person with moderate to profound sensorineural hearing loss.
This operation was performed using L-shape incision technique through retroauricular approach.
The type of cochlear implants used here is MEDEL

Techniques
Facial recess approach

Pericanal technique
- C shape
- J shape
- Inverted U
- A least across-segment variance (LASV) S
- Straight

Part of Cochlear implant
External
- Microphone
- Speech processor
- Transmitter

Internal
- Receiver and stimulator
- An array of up to 22 eletrodes

Type of Cochlear implant
- Advanced Bionics
- Nucleus
- MED-EL

Application
- Bilateral severe to profound Sensorineural Hearing Loss (SNHL)
- Little or no benefit fromm hearing aids
- no medical contraindication for surgery
- Realistic expectation
- adequate cognitive function to be able to use the device

Complication
Elary stage
- Scalp flap problems ( Infection, Necrosis, Thickness )
- Otitis media
- Meningitis
- Facial nerve paralysis
- Tinnitus
- Vertigo
- Device migration
- Device failure
- Facial nerve stimulation

Late stage
- Exposure of device & extrusion
- Displacement of device
- Pain at the site of implant
- Device failure

Sex
Male

Age
63

Diagnosis
Sensorineural Hearing Loss, Both

Chief Complaint
Hearing loss, Both

Medical Devices

■ Microscope : CarlZeiss Pentero

■ Navigation : N/A

■ Surgical Drill : B. BRAUN Aesculap

■ 3D Camera : 3DMedivision M-Flix

■ 3D Recorder : 3DMedivision R-Flix

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Play	Title	Time code
	L-shaped retroauricular skin incision	00:01:20
	Musculoperiosteal flap incision	00:03:56
	Cortical mastoidectomy	00:05:04
	Identification of the antrum	00:06:15
	Posterior tympanotomy	00:07:46
	Exposure of the round window niche	00:10:12
	Soft tissue harvest	00:12:45
	Placing PDS 2-0 suture into the holes	00:15:53
	Opening the round window	00:17:45
	Applying the dexamethasone to round window for prevention of residual hearing	00:17:55
	Inserting the electrode array in the scala tympani through the round window	00:18:10
	Securing and sealing the electrode array using soft tissue and fibrin glue	00:19:07
	Wound closure	00:20:20
	Post OP X-ray	00:22:27