Publication:

Fossa incudis approach in cochlear implant surgery: safe and easy technique for facial nerve preservation during posterior tympanotomy

Background Cochlear implant surgery became worldwide operation used to manage patients with severe to profound sensory neural hearing loss that were not benefit from hearing aids. Facial nerve (FN) injury during the surgery still the most complication that the surgeons think about it during doing posterior tympanotomy.

Methods A retrospective study including 76 patients complaining of severe to profound SNHL, get implanted in Misrata Medical Center, Misrata city, Libya, in the period between January 2018 and April 2020, using our new technique: Fossa incudis approach (FIA), in which and after cortical mastoidectomy performed, exposure of tip of short process of incus which situated in fossa incudis was done to become guide and help us to enter middle ear safe.

Results After 76 operations performed on 76 patients with different anatomical situations, we report 0% FN injury. The time of surgery was relatively shorter (90 minutes±10).

Conclusions Our technique (FIA) is safe and easy to learn; it helps us to minimize the incidence of FN injury and decrease the time of operation.