Padma Shri Dr. Jitender Mohan Hans
Dr. Hans Centre for ENT, Hearing Care & Vertigo, India
Title: Understanding temporal bone aqueducts in cochlear implant surgery
Biography
Biography: Padma Shri Dr. Jitender Mohan Hans
Abstract
Aim: To understand and assess the presence of abnormal cochlear aqueduct and vestibular aqueduct and their presentation during cochlear implant surgery
Methods: The study involved 100 cases of a large cochlear aqueduct and 50 cases of large vestibular aqueduct which were identified on radiological assessment prior to surgery. The cases were operated by the same surgeon and by VERIA technique. The large cochlear aqueducts presented with CSF gushers after cochleostomy and the large vestibular aqueducts presented as pulsatile leak of perilymph. The cochleostomy in large cochlear aqueducts and the large vestibular aqueducts cases were sealed at the time of the CSF leak by the three handed technique in VERIA technique with a dumbbell shaped tissue seal or by using the specially designed electrode array.
Results: Large cochlear aqueducts presented with CSF gushers on cochleostomy which required a better preparedness during surgery to seal the cochleostomy at the time of the gusher to obtain a complete seal and the large vestibular aqueducts presented as a mild pulsatile leak of perilymph which was self-limiting and was easily sealed using tissue. All cases were sealed well at the cochleostomy and did not require any lumbar drain.
Conclusion: Better access provided by VERIA technique provides the surgeon a complete access to the cochlea which enables a three handed control of the gushers for better sealing of cochleostomy. Knowing the aqueducts radiologically prior to surgery is a must for every cochlear implant surgeon.