Thieme Surgery for Cochlear and Other Auditory Implants 1st edition by Sanna Mario, Paul Merkus, Rolien Free, Maurizio Falcioni ISBN B0CMK4DFQM 978-3132581616

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ISBN 10: B0CMK4DFQM
ISBN 13: 978-3132581616
Author: Sanna Mario, Paul Merkus, Rolien Free, Maurizio Falcioni

This comprehensive, high-level surgical reference and atlas is tailored for surgeons who are undertaking training for cochlear implant procedures and implantable auditory devices and for experienced surgeons who would like to expand their knowledge, improve their skills and outcomes, and learn advanced surgical techniques.

Following the principle underlying Professor Sanna’s other successful publications, Surgery for Cochlear and Other Auditory Implants takes an integrated approach to anatomy, imaging, technology, decision making, surgical procedures described step by step, and clinical cases.

Thieme Surgery for Cochlear and Other Auditory Implants 1st Table of contents:

1 History of Auditory Implantation

1.1 Forerunners

1.1.1 Alessandro Volta 

1.1.2 Homer Dudley: the Vocoder

1.1.3 Wever and Bray: the Cochlear Microphonic

1.1.4 S.S. Stevens: Electrophonic Hearing

1.2 Pioneers and Experimentation

1.2.1 In France

1.2.2 Early American Years

1.2.3 Later American Years

1.3 Feasibility, Safety, and Evaluation Studies

1.3.1 The Bilger Report

1.4 Development of a Multichannel Device

1.4.1 United States, Australia, Austria, and France

1.4.2 Graeme Clark, Melbourne University Australia (1935)

1.4.3 Anxiety and Hostility in Deaf Communities

1.5 Development of the Auditory Brainstem Implant

1.5.1 Auditory Brainstem Implant

1.5.2 Summary of Discoveries and Developments

1.5.3 New Developments and Future

2 Surgical Anatomy in Auditory Implantation

2.1 Anatomy of the Middle Ear and Mastoid

2.1.1 The Mastoid

2.1.2 The Antrum

2.1.3 The Tympanic Cavity

2.1.4 The Ossicles

2.1.5 The Oval Window

2.1.6 The Facial Nerve

2.1.7 The Chorda Tympani

2.1.8 The Cochleariform Process and Tensor Tympani Muscle

2.1.9 The Round Window

2.1.10 The Facial Recess and the Posterior Tympanotomy

2.1.11 The Labyrinth

2.1.12 The Sigmoid Sinus and Jugular Bulb

2.1.13 The Carotid Artery

2.1.14 Facial Recess versus Subtotal Petrosectomy

2.2 Anatomical Dissection of Left Temporal Bone for Cochlear Implantation

2.3 Anatomy of the Lateral Skull Base, Brainstem, and Cochlear Nucleus

2.3.1 Internal Auditory Canal

2.3.2 Anatomy of the Posterior Fossa Related to ABI Surgery

3 Radiology in Auditory Implantation

3.1 General Radiology of the Temporal Bone

3.1.1 Computed Tomography

3.1.2 Magnetic Resonance Imaging

3.2 Radiology in Cochlear Implantation

3.3 Radiology in Auditory Brainstem Implantation

3.4 Axial and Coronal CT Sections

3.4.1 CT Mastoid Axial Images

3.4.2 CT Mastoid Coronal Images

3.5 Magnetic Resonance Imaging

3.5.1 Artifact of Cochlear and Auditory Brainstem Implant on MRI

4 Instruments and Implants

4.1 Cochlear Implantation: Instruments, Monitoring, and Implants

4.1.1 Instruments for Cochlear Implant (CI) Surgery

4.1.2 Perioperative Medication in CI Surgery

4.1.3 Monitoring and Electrophysiologic Testing during CI Surgery

4.1.4 Cochlear Implants and Electrodes Currently Available

4.2 Auditory Brainstem Implantation: Instruments, Monitoring, and Implants

4.2.1 Surgical Instruments in ABI Surgery

4.2.2 Management of Bleeding in ABI Surgery

4.2.3 Monitoring of Facial and Cochlear Nerves in ABI (or CI) Surgery

4.2.4 Intraoperative Cochlear Nerve Monitoring (ABR and CNAP)

4.2.5 Perioperative Medication and Care in ABI Surgery

4.2.6 Implants for Brainstem Implantation

5 Cochlear Implantation

5.1 Cochlear Implant Candidates

5.2 Etiology of Hearing Loss

5.3 Current Indications for Cochlear Implantation

5.3.1 Contraindications for Cochlear Implantation

5.3.2 Special Indications, Differential Work-up, and Special Surgical Techniques

5.4 Surgical Steps

5.4.1 Skin Incision

5.4.2 Musculoperiosteal Layer

5.4.3 Mastoidectomy and Posterior Tympanotomy

5.4.4 Exposure of the Round Window

5.4.5 Drill-out of the Receiver Well

5.4.6 Fixation of the Implant

5.4.7 Cochleostomy

5.4.8 Insertion of the Cochlear Electrode

5.4.9 Electrophysiologic Testing

5.4.10 Fixation of the Implant

5.4.11 Closure

Cases 5.1-5.2

5.5 Risks and Complications of Cochlear Implantation

6 Special Considerations in Pediatric Cochlear Implantation

6.1 Position of the Facial Nerve

6.2 The Anatomical Relations between the Facial Recess, the Round Window, and the Basal Turn in Chil

6.3 Growth of the Temporal Bone

6.4 Bone Marrow and Blood Loss

6.5 Fixation of the Receiver-Stimulator

6.6 Anesthesiologic Technique

6.7 Electrophysiologic Measurements

6.8 Bilateral Pediatric Cochlear Implantation

6.8.1 Surgical Considerations in Bilateral Implantation

6.8.2 Special Steps in Bilateral Implantation

7 Complications and Revision Surgery in Cochlear Implantation

7.1 Major Complications

7.2 Minor Complications

7.3 Device Failure Complications

7.3.1 Hard Device Failure

7.3.2 Soft Device Failure

7.4 Pediatric vs. Adult Complication Rate

7.5 Bilateral vs. Unilateral Implant Complication Rates

7.6 Therapeutic Options for Several Complications

7.6.1 Flap Infection/Subcutaneous Hematoma or Seroma

7.6.2 Receiver-Stimulator or Electrode Extrusion

7.6.3 Facial Nerve Stimulation

7.6.4 Facial Nerve Injury

7.6.5 Electrode Placement

7.6.6 CSF Gusher/CSF leakage

7.6.7 Revision Surgery/Re-implantation

Cases 7.1-7.10

8 Auditory Brainstem Implantation

8.1 Rationale

8.2 Indications

8.2.1 Neurofibromatosis Type 2

8.2.2 Postmeningitis Ossification

8.2.3 Inner Ear Malformation

8.2.4 Cochlear Nerve Aplasia/Cochlear Nerve Deficiency

8.3 Controversial Indications

8.3.1 Otic Capsule Fracture and Cochlear Nerve Avulsion

8.3.2 Bilateral or Unilateral Patent Cochlea

8.3.3 Vestibular Schwannoma in the Only Hearing Ear

8.3.4 Autoimmune Inner Ear Disease

8.3.5 Von Hippel-Lindau Disease

8.3.6 Auditory Neuropathy

8.3.7 Otosclerosis

8.4 Indications for ABI/CI: Summary

8.5 Surgical Steps of Auditory Brainstem Implantation

8.5.1 Surgical Anatomy

8.5.2 Surgical Approach

8.5.3 Intraoperative Monitoring

8.6 Surgical Anatomy in Auditory Brainstem Implantation

8.7 Surgical Steps in Auditory Brainstem Implantation

8.8 Surgical Steps According to the Indication

8.9 Summary of Auditory Brainstem Implants

9 Electroacoustic Stimulation

9.1 Hearing Preservation and Electroacoustic Stimulation

9.2 Indication for EAS

9.3 Influential Factors in Hearing Preservation

9.3.1 Atraumatic Surgical Technique

9.3.2 Atraumatic Electrode Design

9.3.3 Perioperative Use of Medication

Cases 9.1-9.2

10 Subtotal Petrosectomy in Cochlear Implantation

10.1 Indications

10.1.1 Chronic Otitis Media/Cholesteatoma/Osteoradionecrosis of the Temporal Bone

10.1.2 Presence of a Radical Cavity/Canal Wall Down Technique

10.1.3 Cochlear Ossification/Obliteration

10.1.4 Inner Ear Malformations

10.1.5 Fracture of the Temporal Bone with Otic Capsule Involvement

10.1.6 Revision Cases

10.1.7 Unfavorable Anatomical Conditions for Posterior Tympanotomy

10.2 Contraindications

10.3 Surgical Procedure

10.3.1 Skin Incision

10.3.2 Anterior Pedicled Flap

10.3.3 Blind-sac Closure of the External Meatus

10.3.4 Removal of the Skin of the Lateral Portion of the External Ear Canal

10.3.5 Canal Wall Down Mastoidectomy

10.3.6 Removal of the Skin of the Medial Portion of the External Ear Canal with Annulus, Malleus, an

10.3.7 Exposure and Closure of Eustachian Tube

10.3.8 Drill-out of the Receiver Well

10.3.9 Harvesting of Abdominal Fat

10.3.10 Exposure of the Round Window

10.3.11 Insertion of the Cochlear Electrode

10.3.12 Electrophysiologic Testing

10.3.13 Fixation of the Implant

10.3.14 Obliteration of Cavity with Fat

10.3.15 Closure

Case 10.1

11 Cochlear Implantation in Cochlear Ossification

11.1 Fibrosis and Ossification Process

11.2 Management Work-up

11.2.1 Fast Diagnostic Work-up

11.2.2 Extended Diagnostic Work-up

11.3 Audiometric Evaluation

11.4 CT and MRI

11.4.1 Fibrosis and Ossification on Imaging

11.5 Surgical Planning

11.5.1 Classification of Ossification and Surgical Strategy

11.5.2 Autoimmune Inner Ear Disease

11.6 Indication for Bilateral Implantation

11.7 Creating Awareness

11.8 Surgical Steps in Ossification

11.8.1 Partial Drill-out of the Basal Turn

11.8.2 Scala Vestibuli Insertion

11.8.3 Complete Basal Turn Drill-out

11.8.4 Middle Turn Cochleostomy with Double Array Insertion

11.8.5 Middle Turn Drill-out with Double Array Insertion

11.8.6 No Lumen Found: Indication for ABI

11.9 Types of Electrodes

11.9.1 Dummy Electrode

Cases 11.1-11.3

11.10 Risks in Surgery for Ossified Cochlea

12 Meningitis and Implantation

12.1 Introduction

12.2 Hearing Loss after Bacterial Meningitis

12.3 Audiologic Follow-up after Meningitis

12.4 Postmeningitis Hearing Evaluation and Treatment Flowchart

12.4.1 First Hearing Evaluation

12.4.2 Dexamethasone

12.4.3 Obliteration

12.4.4 Hearing Loss of 30 dB or More

12.4.5 Radiologic Phases of Inflammation, Fibrosis, and Ossification14,23,24

12.5 Early Postmeningitis Radiology and Decision Making

12.5.1 Unilateral Hearing Loss and Radiology

12.5.2 Bilateral 0-30 dB Loss and Radiology

12.5.3 Bilateral 30-70 dB Loss and Radiology

12.5.4 Bilateral > 70 dB Loss and Radiology

12.6 Difficulties in the Assessment Phase

12.6.1 Audiologic Assessment in Infants

12.6.2 Imaging in Infants

12.6.3 Other Sequelae of Meningitis

12.6.4 Counseling Parents

12.7 Decision Making

12.7.1 Hearing and MRI Assessment

12.7.2 Ossification

12.7.3 ABI in Postmeningitis Cases

Cases 12.1-12.6

13 Auditory Implantation in Otosclerosis Patients

13.1 Otosclerosis

13.2 CT Classification in Otosclerosis

13.3 Decision Making in Otosclerosis

13.4 Treatment Algorithm

13.5 Surgical Difficulties and Management in Cochlear Implantation in Advanced Otosclerosis

Cases 13.1-13.8

14 Otomastoiditis and Cochlear Implantation

14.1 Chronic Suppurative Otitis Media

14.1.1 Preoperative Evaluation

14.1.2 Surgical Treatment

14.1.3 Postoperative Imaging

14.1.4 Special Populations

14.2 Otitis Media with Effusion

14.3 Postoperative Chronic Middle Ear and Mastoid Disease

14.4 Acute Postoperative Middle Ear and Mastoid Infection

14.5 Removal of Cochlear Electrode and Use of Dummy Electrode

14.5.1 Dummy Electrode

Cases 14.1-14.3

15 Inner Ear Malformations and Implantation

15.1 Introduction

15.2 Embryology

15.3 Classification of Malformations

15.3.1 Malformation of the Membranous Labyrinth

15.3.2 Malformations of the Membranous and Osseous Labyrinth

15.3.3 Malformation of the Cochlear Nerve and Inner Ear Canal

15.4 Cochlear and Auditory Brainstem Implantation in Malformations

15.4.1 Cochlear Implantation in IP-2

15.4.2 Cochlear Implantation in IP-3

15.4.3 Cochlear Implantation in Cochlear Hypoplasia

15.4.4 Cochlear Implantation in IP-1

15.4.5 Cochlear Implantation in Common Cavity

15.4.6 Cochlear Implantation or ABI in CHARGE

15.4.7 ABI or CI in Common Cavity or Aplasia of the Cochlea?

15.4.8 ABI or CI in Cochlear Nerve Aplasia or a Small IAC?

15.4.9 Auditory Brainstem Implantation in Labyrinthine Aplasia (Michel Deformity)

15.5 Risks in Malformation CI Surgery

15.5.1 Facial Nerve Injury

15.5.2 Facial Nerve Stimulation

15.5.3 CSF Gusher

15.5.4 Meningitis

15.5.5 Complications

15.5.6 No Auditory Effect/Nonuse

15.6 Summary

15.6.1 Inner Ear Malformations

15.6.2 Internal Auditory Canal and Vestibulocochlear Nerve Malformations

15.6.3 CI or ABI

15.6.4 Results of Implantation

Cases 15.1-15.7

16 Neurofibromatosis Type 2 and Auditory Implantation

16.1 Difference in Comparison with Sporadic Vestibular Schwannoma

16.2 Clinical Diagnosis

16.3 Clinical Manifestations of Disease

16.4 Management

16.5 Vestibular Schwannoma

16.6 Other Tumors

16.7 Surveillance

16.8 Decision Making

16.8.1 Tumor Size

16.8.2 Preoperative Hearing

16.8.3 Complications of the Tumor

16.9 Type of Operation

16.10 Operation Side

16.11 ABI in Neurofibromatosis Type 2

16.12 Indications and Contraindications for Auditory Brainstem Implants

16.13 Removable Magnet in ABI Implants

16.14 First-side Versus Second-side Surgery

16.15 Promontory Testing

16.16 Surgical Considerations

16.16.1 Intraoperative Monitoring

Cases 16.1-16.5

16.17 Summary of NF2 and Implantation

17 Implantation in Skull Base and Temporal Bone Lesions

17.1 CI versus ABI

17.2 Preoperative Conditions

17.3 Intraoperative Audiometric Testing

17.4 Indications

17.4.1 Skull Base Lesions

17.4.2 Previous Radiotherapy

17.4.3 Non-Skull Base Lesions

17.5 Contraindications and Risks of Implantation in Skull Base Surgery/Neurotology

Cases 17.1-17.4

18 Bone Conduction Implants

18.1 Indications

18.1.1 Audiologic Indications

18.1.2 Otologic Indications

18.2 Contraindications

18.3 Implantable Devices with Transcutaneous Abutment

18.3.1 Preoperative Evaluation

18.3.2 Key Features of the Devices

18.3.3 Specific Indications

18.3.4 Contraindications

18.3.5 Surgical Technique

18.3.6 Postoperative Management and Follow-up

18.3.7 Placement of an Implantable Device with Transcutaneous Abutment Using the Skin Thinning Techn

Cases 18.1-18.2

18.4 Complications

18.4.1 Intraoperative Complications

18.4.2 Postoperative Complications

18.5 Implantable Devices without Transcutaneous Abutment

18.5.1 Preoperative Evaluation

18.5.2 Key Features of the Devices

18.5.3 Specific Indications

18.5.4 Contraindications

18.5.5 Postoperative Management and Follow-up

18.5.6 Placement of the Bonebridge System: Surgical Steps

Case 18.3

18.5.7 Placement of the Alpha System: Surgical Steps

Case 18.4

19 Active Middle Ear Implants: Vibrant Soundbridge

19.1 Indications

19.2 Contraindications

19.3 Preoperative Evaluation

19.4 Postoperative Management and Follow Up

19.5 Surgical Steps: Incus Vibroplasty

19.5.1 Incision of Skin and Soft Tissues

19.5.2 Mastoidectomy and Posterior Tympanotomy

19.5.3 Implant Positioning

19.5.4 Audiometric Testing

19.5.5 Closure

Case 19.1

19.6 Surgical Steps: Round Window Vibroplasty

19.6.1 Incision of Skin and Soft Tissues

19.6.2 Subtotal Petrosectomy

19.6.3 Implant Positioning

19.6.4 Audiometric Testing

19.6.5 Closure

Case 19.2

19.7 Results and Complications of VSB placement

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Tags: Sanna Mario, Paul Merkus, Rolien Free, Maurizio Falcioni, Thieme Surgery, Auditory Implants