Cochlear implantation in a patient with congenital microtia, cochlear hypoplasia, venous anomalies of the temporal bone and laryngomalacia: Challenges and surgical considerations.
Medicine (Baltimore)
; 102(7): e33000, 2023 Feb 17.
Article
em En
| MEDLINE
| ID: mdl-36800592
ABSTRACT
RATIONALE AND PATIENT CONCERNS Congenital hearing loss is often caused by an inner ear malformation, in such cases, the presence of other anomalies, such as microtia, and venous anomalies of the temporal bone and laryngomalacia makes it challenging to perform cochlear implantation surgery. DIAGNOSES This study reports the case of a 28-month-old girl with congenital profound hearing loss, laryngomalacia, and malformed inner ear, who received cochlear implantation surgery. The bony structure, vessels and nerves were first assessed through magnetic resonance imaging and computed tomography before exploring the genetic basis of the condition using trio-based whole exome sequencing. Perioperative evaluation and management of the airway was then performed by experienced anesthesiologist, with the surgical challenges as well as problems encountered fully evaluated. INTERVENTIONS:
Cochlear implantation was eventually performed using a trans-mastoid approach under uneventful general anesthesia.OUTCOMES:
Due to the small size of the cochlea, a short electrode FLEX24 was inserted through the cochleostomy. LESSONS Considering the high risk of facial nerve injury and limited access to the cochlea when patients present significant bony and venous anomalies, cochlear implantation in such patients require careful preoperative evaluation and thoughtful planning. In these cases, airway assessment, magnetic resonance venography, magnetic resonance arteriography, and magnetic resonance imaging and computed tomography can be useful to minimize the risks. Intraoperative facial nerve monitoring is also recommended to assist in the safe location of facial nerve.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Implantes Cocleares
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Implante Coclear
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Malformações Vasculares
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Laringomalácia
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Microtia Congênita
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Perda Auditiva Neurossensorial
Limite:
Child, preschool
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Female
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Humans
Idioma:
En
Revista:
Medicine (Baltimore)
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
China