Cochlear Implantation Requiring a Retrofacial Approach to the Round Window

Abstract

OBJECTIVE: To describe three cases of cochlear implantation utilizing a retrofacial approach to the round window. STUDY DESIGN: Retrospective case review. PATIENTS: Three patients with sensorineural hearing loss undergoing cochlear implantation. INTERVENTIONS: Cochlear implantation via a retrofacial approach to the round window. RESULTS: Three patients were noted to have inadequate visualization of the round window using a standard posterior tympanotomy at the time of their cochlear implant surgery. A retrofacial approach was performed to provide exposure of the round window to ensure correct placement of the electrode array. Intraoperative photos and postoperative imaging are demonstrated. CONCLUSION: When a laterally or anteriorly positioned facial nerve obscures visualization of the round window, a retrofacial approach is a possible route to visualize the round window.