Download 13th International Conference on Cochlear Implants and Other

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Transcript
S3-21
Bilateral round window VSB implantation via subfacial approach
Dai P.
1
1
Chinese PLA General Hospital, Dept Otolaryngology Head Neck Surg, Beijing, China
Objective: To report on experience regarding bilateral round window VSB implantation via subfacial approach
and discuss the efficacy and safety of this novel surgical approach.
Patient: A 16-year-old boy presented with bilateral microtia and osseous atresia, after the reconstruction of the
outer ear.
Methods: The bilateral round window VSB implantations were performed sequentially with a 31-month
interval(the left first, and then the right, the interval time) . During the operations of both sides, the facial nerves
were found displaced inferiorly and anteriorly, causing difficulty in exposing promontory and round window niche.
Accordingly, the sub-facial approach was taken in both sides to get the fully exposure of Round window
membranes (RWM) and place the FMT on the surface of RWM. The safety and efficacy of the technique and
intervention were evaluated by perioperative observation, and auditory follow up.
Results: After VSB fitting of the left side for 36 months and the right side for 5 months, there is no perioperative
or long term postoperative complication observed. The mean aided threshold of four audiometric test
frequencies(0.5k, 1k, 2k, 4 kHz) was 42dB(HL) post-operatively compare to 101 dB(HL) pre-operatively on the
right side, 30 dB(HL) post-operatively compare to 85 dB(HL) pre-operatively on the left side, and 26 dB(HL)
bilateral post-operatively compare to 70 dB(HL) bilateral pre-operatively. Speech discrimination of
monosyllable/disyllable/sentence in quiet conditions and sentence in noise(S/N=+10 dB) with the left and
bilaterally activated was 100% at 65 dB(SPL), and 80% with only right activated.
Conclusion: We reported the first case of bilateral round window VSB implantation via subfacial approach with
satisfactory outcome and long term safety. Our practice offered an alternative procedure to such patients with
microtia and osseous atresia and severe aberrant facial nerve.
Key Words: bilateral VSB implantations, subfacial approach.
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