The temporalis pocket technique for cochlear implantation: An anatomic and clinical study

Thomas J. Balkany, Matthew Whitley, Yisgav Shapira, Simon I Angeli, Kevin Brown, Elias Eter, Thomas R Van De Water, Fred F Telischi, Adrien Eshraghi, Claudiu Treaba

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

OBJECTIVE: To describe the surgical anatomy and clinical outcomes of a technique for securing cochlear implant receiver/stimulators (R/S). Receiver/stimulators are generally secured by drilling a custom-fit seat and suture-retaining holes in the skull. However, rare intracranial complications and R/S migration have been reported with this standard method. Newer R/S designs feature a low profile and larger, rigid flat bottoms in which drilling a seat may be less appropriate. We report a technique for securing the R/S without drilling bone. STUDY DESIGN: Anatomic: Forty-eight half-heads were studied. Digital photography and morphometric analysis demonstrated anatomic boundaries of the subpericranial pocket (t-pocket). Clinical: Retrospective series of 227 consecutive Cochlear implant recipients implanted during a 2-year period using either the t-pocket or standard technique. The main outcome measures were rates of R/S migration and intracranial complications. Minimum follow-up was 12 months. RESULTS: The t-pocket is limited anteriorly by dense condensations of pericranium anteriorly at the temporal-parietal suture, posteroinferiorly at the lamdoid suture, and anteroinferiorly by the bony ridge of the squamous suture. One hundred seventy-one subjects were implanted using the t-pocket technique and 56 using the standard technique, with a minimum follow-up of 12 months. There were no cases of migration or intracranial complications in either group. CONCLUSION: The t-pocket secures the R/S with anatomically consistent strong points of fixation while precluding dural complications. There were no cases of migration or intracranial complication noted. Further trials and device-specific training with this technique are necessary before it is widely adopted.

Original languageEnglish
Pages (from-to)903-907
Number of pages5
JournalOtology and Neurotology
Volume30
Issue number7
DOIs
StatePublished - Oct 1 2009

Fingerprint

Cochlear Implantation
Sutures
Cochlear Implants
Photography
Skull
Anatomy
Teaching
Head
Outcome Assessment (Health Care)
Bone and Bones
Equipment and Supplies
Clinical Studies

Keywords

  • Cochlear implant surgery
  • Complications
  • Deafness
  • Hearing loss
  • Technique

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems

Cite this

The temporalis pocket technique for cochlear implantation : An anatomic and clinical study. / Balkany, Thomas J.; Whitley, Matthew; Shapira, Yisgav; Angeli, Simon I; Brown, Kevin; Eter, Elias; Van De Water, Thomas R; Telischi, Fred F; Eshraghi, Adrien; Treaba, Claudiu.

In: Otology and Neurotology, Vol. 30, No. 7, 01.10.2009, p. 903-907.

Research output: Contribution to journalArticle

Balkany, Thomas J. ; Whitley, Matthew ; Shapira, Yisgav ; Angeli, Simon I ; Brown, Kevin ; Eter, Elias ; Van De Water, Thomas R ; Telischi, Fred F ; Eshraghi, Adrien ; Treaba, Claudiu. / The temporalis pocket technique for cochlear implantation : An anatomic and clinical study. In: Otology and Neurotology. 2009 ; Vol. 30, No. 7. pp. 903-907.
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