COCHLEAR IMPLANTATION IN COMMON CAVITY MALFORMATIONS USING A TRANSMASTOID LABYRINTHOTOMY APPROACH

The transmastoid facial recess approach has become the standard techni que for cochlear implantation. Although this approach has been used fo r implantation in patients with common cavity deformities, it is not w ithout increased risk to the facial nerve. Using a direct approach to the common cavity that circumvents the facial recess, we have successf ully implanted four patients with common cavity deformities. An aberra nt facial nerve in one patient would have precluded placement of the e lectrode array using standard cochlear implant techniques, As demonstr ated in these four patients, the direct approach to the common cavity is an effective approach for placement of the electrode array, minimiz es risk to the facial nerve, and may decrease the likelihood of postop erative cerebrospinal fluid leaks. Intraoperative video footage demons trates the feasibility and facility of this approach in patients with common cavity deformities.