Background and rationale
sensorineural hearing loss
BILATERAL HEARING LOSS, COMPLICATIONS, CORTEX, SENSORINEURAL HEARING LOSS
Cochlear implants (CIs) provide hearing through direct electrical stimulation of the auditory nerve in patients with sensorineural hearing loss and have become standard care for adult and pediatric patients with severe to profound bilateral hearing loss. Cochlear implantation surgery requires careful planning and execution. The correct electrode array positioning in the cochlea is crucial for optimal functionality of the device. This array is connected to the body of the implant, known as the receiver/stimulator (R/S) device. During cochlear implantation, the R/S device is placed and fixated on the skull. It should be placed close to the pinna, without possible interference of the microphone in the behind-the-ear device laying (partially) on top of the R/S device.The standard fixation technique of the R/S device, which is recommended by the surgeon’s guide that is supplied with the respective implants, consists of drilling out a part of the bony cortex of the skull (a bony recess), as well as non-absorbable suture retaining holes [Complications that can occur as a result of failed fixation of the R/S is a shift/migration of the internal components of the implant: the R/S device itself and the electrode array [A minimally invasive technique that does not require drilling out a bony recess, known as the subperiosteal tight pocket technique, was first described by Balkany et al. in 2009 [Since the publication of the study by Balkany et al. in 2009, many ENT specialists are applying the tight subperiosteal technique [