title: 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.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Three patients with sensorineural hearing loss undergoing cochlear implantation.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: *Tampa Bay Hearing and Balance Center, Tampa, Florida; and †Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
authors.forename: Kyle P
authors.initials: KP
authors.lastname: Allen
authors.forename: Loren J
authors.initials: LJ
authors.lastname: Bartels
authors.forename: Brandon
authors.initials: B
authors.lastname: Isaacson
mesh_terms: D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012405:Round Window, Ear / Q000601:surgery*; D016896:Treatment Outcome