Report of endoscopic cochlear implantation.

Objectives: To report patient outcomes after transcanal endoscopic cochlear implantation for sensorineural hearing loss.

Patients: Males and female subjects more than 7 years old with sensorineural hearing loss (confirmed with audiologic studies) were selected. CT imaging was used to rule out any anatomic anomalies of the temporal bone. Smaller pediatric patients whose canal might still be growing and who might have a higher incidence of otitis media and otitis externa were excluded. Obese adults whose canal skin was too thick to allow good access down the ear canal were also excluded.

Intervention(s): Surgical (therapeutic). Endoscopic cochlear implantation using a transcanal approach.

Main Outcome Measure(s): Implant position and function. Postoperative complications specifically related to transcanal approach and use of the endoscope.

Results: Twenty-five endoscopic cochlear implantations were performed in 24 ears on 11 female and 10 male subjects aged 7-65 years. Eight patients were implanted in Brazil, and 13 patients (17 yr) were implanted in the United States. All implants were fully inserted into the scala tympani, and 24 functioned normally with appropriate thresholds. Mean time of follow-up was 16 months (SD, ±7.2). The chorda tympani was sacrificed in 2 of 25 procedures, 12 EAC/TM tears occurred which healed by the second follow-up visit. No injury to the facial nerve was observed. One postoperative wound infection and 1 otitis externa each resolved with 1 week of antibiotics. Implant array was visible through the EACs skin but not exposed in 6 of 24 ears.

Conclusion: Endoscopic cochlear implantation may become a viable, safe, and feasible alternative to the standard open transmastoid approach.