title: [Fluoroscopic assisted cochlear implantation in children with inner ear malformations].
abstract: BACKGROUND
  Cochlear implants are the treatment of choice for individuals with severe to profound sensorineural hearing loss. In most cases, the anatomy is normal and the insertion of the electrode-array is straightforward, complete and in the correct position. In the presence of inner-ear malformations, the risk of an intra or extra-cochlear malpositioned electrode-array increases.
  
  
  OBJECTIVE
  To describe the technique of fluoroscopic assisted cochlear implantation in children with severe inner-ear malformations and present the results with respect to the number of active electrodes and function.
  
  
  METHODS
  Fifteen fluoroscopy assisted implantations in 9 children were conducted at the Shaare Zedek Cochlear Implant Center between 2009-1014. All implanted ears had severe anatomic malformations. Mean implantation age was 3.5 years (range 1-11). Six children underwent sequential bilateral implantation. Two children underwent revision surgery due to a malpositioned electrode initially implanted without fluoroscopy at other centers.
  
  
  RESULTS
  There was no radiologic or electro-physiologic evidence of kinking, bending or electrode damage in all 15 implantations. Complete insertion was achieved in all ears except one with partial insertion. There were no extra-cochlear or intrameatal placements. In 9 ears, all electrodes were active at switch-on and in the remaining, 15-20 were active. In all ears the Ling-6 sounds were detected and in 13 they were also identified.
  
  
  CONCLUSIONS
  Fluoroscopy is an effective tool in complex cochlear implant surgeries and its use is simple and safe. As demonstrated in this study, with fluoroscopy assistance, good results are achieved in children with inner-ear malformations.
authors: Ronen
authors: R
authors: Perez
authors: Riki
authors: R
authors: Salem
authors: J Thomas
authors: JT
authors: Roland
authors: Jean Yves
authors: JY
authors: Sichel
mesh_terms: D002675:Child, Preschool; D003051:Cochlea / Q000002:abnormalities / Q000601:surgery; D015834:Cochlear Diseases / Q000151:congenital / Q000601:surgery; D019929:Cochlear Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D003054:Cochlear Implants; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D007557:Israel; D008297:Male; D012189:Retrospective Studies; D020379:Risk Adjustment; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome