title: A New Surgical Approach for Direct Acoustic Cochlear Implant: A Temporal Bone Study.
abstract: OBJECTIVE
  The direct acoustic cochlear implant (DACI) is among the latest developments in the field of implantable acoustic prostheses. The surgical procedure requires a mastoidectomy and a posterior-inferior tympanotomy, with access to the facial recess at the level of the oval window, in a complex and lengthy surgical approach. Here, we report a new and considerably shorter surgical approach.
  
  
  METHODS
  The new approach involves positioning of artificial incus above the oval window through the superior-anterior tympanotomy. We performed DACI placement in temporal bone specimens (n=5) to assess the feasibility of the new approach.
  
  
  RESULTS
  The average time for the DACI implant in the temporal bones was only 112 minutes (range, 94 to 142 minutes) and there was little clinical risk associated with the procedure. Access was easy and drilling was minimal.
  
  
  CONCLUSIONS
  Our approach simplified the surgical procedure and consequently reduced the time required for DACI placement.
authors.affiliation: ENT Audiology and Phoniatry Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bruschini
authors.affiliation: ENT Audiology and Phoniatry Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Forli
authors.affiliation: ENT Audiology and Phoniatry Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Andrea De
authors.initials: A
authors.lastname: Vito
authors.affiliation: ENT Audiology and Phoniatry Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Berrettini
keywords: Acoustics; CODACS; Prostheses and Implants; Tympanotomy