COCHLEAR IMPLANT METHOD FOR PATIENTS AT RISK OF FACIAL NERVE STIMULATION Russian patent published in 2023 - IPC A61F2/00 A61F11/04 A61F11/20 A61B17/00 

FIELD: medicine; otorhinolaryngology.

SUBSTANCE: prior to surgery, the protector is prepared from a fragment of sterile rubber latex-dielectric. An S-shaped incision in the behind-the-ear region is performed, skin and muscle-periosteal flaps are formed and exfoliated. A fragment of autofat is taken from the edges of the wound. Then, a bed is prepared for the body of the cochlear implant, the cortical layer is ground down in the form of a groove for laying the active electrode. Layer-by-layer sawing of the mastoid process along the external auditory canal is performed with visualization of the posterior tympantomy area. The tympanic cavity is opened with the identification of the long process of the incus, the head and posterior leg of the stirrup, the incus-stapedius articulation, the pyramidal process and the tendon of the stapedius muscle, the canopy of the cochlear window. Disconnection of the anvil-stapedius joint is carried out, removal of the incus is performed, expanding access to the tympanic section of the facial nerve. At the same time, the posterior wall of the attic is partially removed above the projection of the incus and the bone bridge in the projection of the incus, providing visualization and the possibility of performing manipulations in the area of the tympanic part of the facial nerve. Then, the protector is laid with an opening angle of 120 degrees in the space between the tympanic section of the facial nerve and the basal whorl of the cochlea at the intersection of the anatomical structures with each other at the specified angle. At the same time, in the process of laying the tread, auto-grease is applied on both sides of it before laying. Next, the canopy of the snail window is identified, the membrane of the snail window is opened. The implant body is fixed in the prepared bed and the active electrode of the cochlear implant is inserted into the cochlea. After that, telemetry of the implant is performed and the wound is sutured in layers.

EFFECT: method allows to improve the quality of hearing and speech rehabilitation by reducing the risk of stimulation of the facial nerve during the operation of the cochlear implant.

1 cl, 4 dwg, 1 ex