title: Anteroposterior approach with split ear canal for cochlear implantation in severe malformations.
abstract: OBJECTIVE
  To present an anteroposterior approach with split ear canal technique in severe malformed ears in which cochlear implantation is not possible through the standard facial recess approach.
  
  
  METHODS
  The operation was performed at Hacettepe University Medical Faculty, which is a tertiary care center.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A 4-year-old female patient with severe Mondini malformation whose facial nerve was completely dehiscent and overlying the stapes and round window.
  
  
  METHODS
  The anteroposterior approach was used, and the middle ear was entered after the tympanomeatal flap was elevated. The posterior wall of the ear canal was split longitudinally with a diamond drill. The electrode was inserted easily through the ear canal and then transferred into the mastoid.
  
  
  CONCLUSIONS
  The anteroposterior approach with split ear canal method may be used if, during facial recess, the landmarks in the middle ear (stapes, stapedius tendon, round window, and promontory) cannot be identified clearly because of an abnormal facial nerve (coursing anteriorly, preventing the use of a drill). It is an alternative for the canal wall down procedure.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Medical Faculty, Ankara, Turkey. lsennar@tr.net
authors.forename: Levent
authors.initials: L
authors.lastname: Sennaroglu
authors.forename: Erdinç
authors.initials: E
authors.lastname: Aydin
mesh_terms: D000015:Abnormalities, Multiple; D002675:Child, Preschool; D003051:Cochlea / Q000002:abnormalities*; D019929:Cochlear Implantation; D004424:Ear Canal / Q000601:surgery*; D004429:Ear Ossicles / Q000637:transplantation; D007758:Ear, Inner / Q000000981:diagnostic imaging; D004567:Electrodes, Implanted; D005154:Facial Nerve / Q000002:abnormalities*; D005260:Female; D006801:Humans; D008416:Mastoid / Q000002:abnormalities*; D013506:Otologic Surgical Procedures / Q000379:methods; D012720:Severity of Illness Index; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000637:transplantation; D014722:Vestibule, Labyrinth / Q000000981:diagnostic imaging