Minimal Invasive Technique (VERIA) for Cochlear Implantation
The conventional or the classic technique uses a mastoidectomy & posterior tympanotomy approach to the middle ear & the cochlea. Though it is a successful technique it is more time consuming & prone to various complications specially in small children with a small Facial Recess, anomalies of the cochlea, cochlear rotation, etc. In the era of Minimal invasive techniques & need for better accessibility (of the cochlea in this case) the Trans-canal or the Veria Technique is very helpful. This technique is almost becoming essential now, since the time cochlear implantation has been started in children.
The small Tunnel 1.6 mm. in diameter for electrode insertion in transcanal minimal invasive technique for cochlear implantation
The large mastoid cavity for posterior tympanotomy in the conventional technique for cochlear implantation
The small Tunnel 1.6 mm. in diameter for electrode insertion vis-a-vis the large mastoid cavity for posterior tympanotomy
In this case a Trans-canal Tunnel is created with a special "Perforator" in the cortex of the posterior canal wall, which enters the middle ear through the facial recess. A tympano-meatal flap is elevated to do the Cochleostomy & insertion of the electrode in the scala-tympani.
Cochlear Implant in a child
I have done over 1800 cases by this technique, in my centre and in centers around India and SAARC countries including Pakistan & Bangladesh, with no surgical complications till date and withvery good post-op results, in patients ranging from 9 months to 79 years, both pre-lingual & post lingual.
Varity of cases with Middle ear cleft anomalies like dehiscent high jugular bulb, anteriorly placed sigmoid sinus; Cochlear anomalies like Mondini & Single cavity cochlea; Cochlear dystrophies (osteogenesis imperfecta); Cochlear ossification etc. were done. Situations like Intra-op CSF Gusher’s were dealt with ease.
I have used all the 4 Cochlear Implant systems available in the world namely Med'el, Nucleus, Advanced Bionics and Neuralac Digisonic, with very good results by this techniques.
12 Cochlear Implant Surgeries done in two days - Raipur
5 Cochlear Implant Surgeries done in one day at Koti ENT Hospital Hyderabad
12 Cochlear Implant Surgeries done in two days again at Raipur on another day
Child with Bilateral Cochlear Implant from Kazakistan operated by Dr. Hans in Delhi
Baby Rajshree from Nepal operated by Dr. Hans in Delhi
Cochlear Implant in a child from Afghanistan