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Round Window/Cochleostomy

Round Window/Cochleostomy. both approaches acceptable round window is the most important landmark is the round window. Courtesy Dr. Chang- xue Wang. Cochleostomy vs. Round Window. bone in round window steeper angle at first turn contact hard to pack/seal destroys the membrane

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Round Window/Cochleostomy

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  1. Round Window/Cochleostomy • both approaches acceptable • round window is the most important landmark is the round window Courtesy Dr. Chang-xue Wang

  2. Cochleostomy vs. Round Window • bone in round window • steeper angle at first turn contact • hard to pack/seal • destroys the membrane • permeability • CHL stapes tendon right ear bone in hook region

  3. Electrode in the Vestibule! Courtesy of ManoharBance

  4. Cochleostomy vs. Round Window • bone in round window • steeper angle at first turn contact • hard to pack/seal • destroys the membrane • permeability • CHL right ear cochleostomy round window

  5. Cochlear Vasculature Courtesy of Peter Roland

  6. Cochleostomy vs. Round Window • no bone dust • correct scala • easier?

  7. Cochleostomy vs. Round Window • no bone dust • correct scala • easier?

  8. Insertion • insertion technique • round window • extended round window • cochleostomy Round Window Extended RW Cochleostomy

  9. Depth of Insertion Round Window 290º ± 60 Extended RW 325º ± 60 Cochleostomy 320º ± 28

  10. Current Opinion • either approach: • identify round window fully • is acceptable • can preserve hearing

  11. Current Opinion • round window approach: • favoured in thin electrodes • cochleostomy: • favoured in anomalies • pre-curved electrodes

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