A new instrument for minimal access surgery in cochlear implantation

Objective: Evaluation of usefulness and benefits of a new hand-held retractor for minimal invasive technique in cochlear implantation. Setting: Tertiary medical center. Patients: Fourteen consecutive patients (age: 1-83; 4 = female and 10 = male) received a cochlear implant in minimal invasive technique using the new hand-held retractor. Intervention: Standardized operation procedure in minimal invasive technique for cochlear implantation. A short retro-auricular incision is used to perform the mastoidectomy with posterior tympanotomy and cochleostomy. Results: The hand-held retractor allows drilling of the bony well for the receiver-stimulator package under direct vision from an anterior position of the surgeon. The sub-periosteal pocket is performed while maintaining continuous suction of irrigating fluids with no further assistance needed. Conclusion: With the new retractor, up to 70% of time to create the bony well is saved compared to previously used instrumentation. The retractor might be further useful in different fields of surgery where the operating field needs to be visualized with the integrated suction and light-device under protection of the surrounding tissue.