title: Soft cochlear implantation: rationale for the surgical approach.
abstract: Recent advances in cochlear implant technology have focused renewed attention on the preservation of residual hearing. The focus on preservation of residual hearing is driven by the concept of electroacoustic stimulation. This option depends on the insertion of a short cochlear implant electrode into the basal region of the cochlea while preserving native function in the apical region. The desire to preserve residual hearing has led to the development of the soft-surgery cochlear implantation technique. Here, the authors evaluate its various components. Avoiding entry of blood into the cochlea and the use of hyaluronate seem to be reasonably supported, whereas the use of topical steroids is unlikely to be beneficial. The site of entry into the cochlea, the use of contoured or straight devices, and the depth of insertion are also evaluated. The authors highlight the importance of systematic recording of outcomes and surgical events.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA. dfriedla@mcw.edu
authors.forename: David R
authors.initials: DR
authors.lastname: Friedland
authors.forename: Christina
authors.initials: C
authors.lastname: Runge-Samuelson
mesh_terms: D003051:Cochlea / Q000601:surgery*; D019929:Cochlear Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D003054:Cochlear Implants; D012048:Correction of Hearing Impairment; D003638:Deafness / Q000503:physiopathology / Q000534:rehabilitation*; D004867:Equipment Design; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D010030:Ostomy / Q000009:adverse effects / Q000295:instrumentation; D019986:Persons with Hearing Disabilities; D017410:Practice Guidelines as Topic; D011474:Prosthesis Design; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013256:Steroids; D006820:Hyaluronic Acid