Keyhole Cochlear Implantation: Current Status

Introduction: Past cochlear implantation (CI) techniques have included a variety of soft tissue and bony trauma to place and stabilize the implant body. Despite minimalist approaches, the surgery invites further refinement. Materials and Methods: A restricted access "keyhole'' CI technique was developed through a series of 547 cases undertaken from 1997. The surgery used a 20-mm-diameter mini C-incision on the rear of the auricle and avoided the use of a bony retention well or suture fixation. Initial body migration rates were successfully countered using small titanium mesh "bridges.'' The series was free from other problems specific to the technique. Discussion: The study demonstrates that CI can be performed with only restricted exposure, disposing of well and suture fixation methods, and without a wound that may be adjacent to the implant body or electrode arrays. Conclusion: The keyhole approach proved atraumatic and brief. It is particularly suited to simultaneous bilateral implantation in the infant and proved adaptable to all ages.