Int. Adv. Otol. 2009; 6(1); 29-33

The mastoid cavity after CI surgery with the mastoid saving surgical approach method.
Rinze A. Tange, Wilko Grolman
Dept of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, the Netherlands

Objective: To study postoperative status of the mastoid cavity after cochlear implantation by the suprameatal approach
method.

Methods: Pre- and postoperative protocolair prepared CT-scans of the mastoid cavity of patients who were operated for
cochlear implantation were studies. 79 patients were included in this study. All patients were operated by the two authors using
a mastoid saving surgical suprameatal approach for cochlear implantation . The postoperative CT-scans were evaluated after
6 months or more after surgery. Changes of the state of the mastoid observed by CT scan were documented.

Results: In 76 cases no abnormalities were observed in the mastoid of the operated ear for cochlear implantation. The delicate
structures of the mastoid cavity were kept intact without any sign of mucosal reaction. In two cases of implantation for deafness
due to otosclerosis swollen mucosa was observed in the mastoid without any clinical relevance. In one case (a child)
opicafication of the whole mastoid and middle ear was observed without destruction of the structures of the mastoid. Treatment
with oral antibiotics cured this otitis media without rest reactions in the mastoid

Conclusions: The delicate structures of the mastoid cavity can be kept intact using a mastoid saving suprameatal surgical
approach in cochlear implant surgery. In almost all the cases we could demonstrate by CT-scan that there is not any reaction
of the mucosa in the mastoid and middle ear after cochlear implantation. There were no differences in the postoperative state
of the small or large pneumatized mastoid.