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Cochlear Implant Fixation and Dura Exposure

Yoshikawa, Noriko*; Hirsch, Barry*†; Telischi, Fred F.

doi: 10.1097/MAO.0b013e3181dd1400
Cochlear Implants

Objective: To determine the current common practices and techniques used to fixate and stabilize internal receivers.

Study Design: Retrospective, anonymized, cross-sectional survey.

Setting: William House Cochlear Implant Study Group Meeting in September 2008.

Results: A total of 62 surveys were received of the 106 people who had signed in. In adults, 83.3% of the respondents said that they always, 6.7% usually, 3.3% sometimes, 3.3% rarely, and 3.3% never drilled wells for the internal receiver. In pediatric patients, respondents said that they would always 78.6%, usually 8.9%, sometimes 3.6%, rarely 5.4%, and never 3.6% drill wells. Regarding the securing of the internal receiver, 56.1% always, 10.5% usually, 3.5% sometimes, 12.3% rarely, and 17.5% never secured the internal receiver in adults. In the pediatric patient population, 50% always, 12.5% usually, 7.1% sometimes, 12.5% usually, and 17.9% never secured the device. In adults, 50% reported using bone holes, 30% fascial sutures, and 20% screws. In the pediatric population, 45.5% indicated that they used bone holes, 34.5% fascial sutures, and 20% screws. Most respondents rarely or never drilled down to the dura for bone holes.

Conclusion: Whereas the majority of respondents do drill wells for the internal receiver in both adults and children, those that did not were represented. The result of this survey emphasizes that alternatives are available and acceptable. There is no significant evidence in the literature to support 1 specific method of fixation.

Departments of *Otolaryngology, †Neurological Surgery, and Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡Otolaryngology, Neurological Surgery, Biomedical Engineering, University of Miami School of Medicine, Miami, Florida, U.S.A.

Address correspondence and reprint requests to Barry Hirsch, M.D., F.A.C.S., 200 Lothrop St, Suite 500, University of Pittsburgh, Pittsburgh, PA 15213, U.S.A.; E-mail:

There was no funding for this study.

None of the authors have any conflicts to disclose.

© 2010 Otology & Neurotology, Inc.