Identification and revision of a displaced cochlear implant electrode in the internal auditory canal.

OBJECTIVE: The aim of the report is to underline the importance of a radiological technique which allows three-dimensional (3D) imaging of the cochlear implant electrode position postoperatively in cases of cochlear malformation, and to show a technique to prevent a repeat of cochlear implant electrode insertion in the internal auditory canal (IAC). CLINICAL PRESENTATION: This report describes the management of a case of insertion of a cochlear implant electrode into the IAC in a 1.5-year-old patient with an incomplete partition (IP) III cochlear malformation. INTERVENTION AND TECHNIQUE: The commonly used single plain postoperative X-ray is not sufficient to be certain of detecting the incorrect insertion of a cochlear implant electrode in the case of a malformed cochlea. In this case, 3D radiology allowed the incorrect insertion to be detected. The original cochlear implant electrode was temporarily left in place under the assumption that it would block the entrance to the IAC and prevent IAC insertion of the replacement electrode. CONCLUSION: Postoperative 3D radiological observation after cochlear implant surgery should be done in cases of malformation. Leaving the original electrode in place can help to prevent a repeat electrode malinsertion.