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Bonebridge and CI surgery under local anesthesia
Manrique M. , Manrique R. , De Abajo J.
University of Navarra Clinic, ENT, Pamplona, Spain
Introduction: The Bonebridge (BB) system and the cochlear implants are a remarkable solution for certain types
of conductive hearing loss or unilateral hearing losses with head shadow effect and sensorineural hearing
losses, respectively. The aims of this article are to describe the surgical technique under local anaesthesia with
the use of both systems.
Material and methods: 6 patients were selected for this new procedure with the BB implant. 5 suffered from a
chronic otitis media (COM) and they had antecedents of failed tymplanoplasties. The sixth patient was surgically
intervened of a left acoustic neuroma. A CT scan processed with the 3DSlicer software allows us to accurately
plan our surgery by digitally placing the BC-FMT on the selected area according to the skull thickness. Two
patients underwent cochlear re-implantation surgery. For the local anaesthesia, we use a combination of
lidocaine and 2% epinephrine. A specially designed surgical cover was used to avoid a claustrophobic effect. To
mask the drilling sound, we used a mp3 player with a headphone on the contralateral ear.
Results: All patients tolerated the surgery without complication and were intervened under local anaesthesia
and the BCI and CI were placed satisfactory.
Conclusions: Implantation of the BB and revision surgery of CI with local anaesthesia is a safe and feasible