title: Endoscopic cochlear implantation: Call for caution.
abstract: OBJECTIVE
  To assess whether transcanal endoscopic access to the basal turn of the cochlea for cochlear implantation is appropriate.
  
  
  METHODS
  Case series study.
  
  
  METHODS
  We reviewed 100 consecutive computed tomographic studies of the sinuses and temporal bone in our institution. We excluded studies that demonstrated evidence of congenital anomalies, chronic ear disease, or inadequate visualization of the cochlea. On axial sections, the angles of the basal turn of the cochlea and of the ear canal in reference to the sagittal plane were recorded as a function of age.
  
  
  RESULTS
  Eighty-four studies were included and 16 were excluded. There was significant variability in the relationship between the ear canal and the basal turn of the cochlea in reference to the sagittal plane. A clear majority of images demonstrated the basal turn of the cochlea to align with a more posterior angle than that of the ear canal.
  
  
  CONCLUSIONS
  The trajectory provided by posterior tympanotomy aligns more favorably with the basal turn of the cochlea than transcanal access. Endoscopic technique, primarily an ear canal intervention, may not be useful in cochlear implant surgery.
  
  
  METHODS
  4. Laryngoscope, 126:689-692, 2016.
authors.affiliation: Department of Otolaryngology, American Hospital Dubai, Dubai, United Arab Emirates.
authors.forename: Muaaz
authors.initials: M
authors.lastname: Tarabichi
authors.affiliation: Department of Otolaryngology, Dubai Hospital, Dubai, United Arab Emirates.
authors.forename: Omar
authors.initials: O
authors.lastname: Nazhat
authors.affiliation: Department of Otolaryngology, Dubai Hospital, Dubai, United Arab Emirates.
authors.forename: Jamal
authors.initials: J
authors.lastname: Kassouma
authors.affiliation: Department of Otolaryngology, American Hospital Dubai, Dubai, United Arab Emirates.
authors.forename: Murtaza
authors.initials: M
authors.lastname: Najmi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000000981:diagnostic imaging / Q000601:surgery*; D019929:Cochlear Implantation / Q000009:adverse effects* / Q000379:methods; D003054:Cochlear Implants; D015331:Cohort Studies; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Endoscopic ear surgery; cochlear implant; endoscopic cochlear implant; transcanal approach