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External Auditory Canal Closure in Cochlear Implant Surgery

El-Kashlan, Hussam K.; Arts, H. Alexander; Telian, Steven A.


Objective To evaluate surgical techniques and complications associated with external auditory canal (EAC) closure in cochlear implant surgery.

Study Design Retrospective case review.

Setting Tertiary referral center with a large cochlear implant program.

Patients Twenty-eight patients (8 adults and 20 children) underwent multichannel cochlear implantation with EAC closure. The follow-up periods ranged between 1 and 10 years. Closure of the EAC was performed in conjunction with implantation of ears with chronic suppurative otitis media or cochlear drill-out procedures for ossification, or for access to the cochlea in patients with abnormal temporal bone anatomy. A modified Rambo technique was used for EAC closure in all but one case.

Interventions Cochlear implantation with EAC closure and subsequent clinical and radiologic follow-up.

Main Outcome Measures Postoperative complications or the development of cholesteatoma in the implanted ear.

Results Cholesteatoma developed in the implanted ear in two patients. Breakdown of EAC closure occurred in one of these patients. The details of these patients are reviewed.

Conclusion Closure of EAC can be done with relatively low risk. Close and careful follow-up is required for early detection of a developing cholesteatoma.

Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.

Address correspondence and reprint requests to Dr. Hussam K. El-Kashlan, Department of Otolaryngology, 1500 East Medical Center Drive, Ann Arbor, MI 48109–0312, U.S.A.; Email:

© 2003 Otology & Neurotology, Inc.