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6 STEPS SKARZYNSKI SURGICAL PROCEDURE STEP 1 – ANTROMASTOIDOTOMY STEP 2 – POSTERIOR TYMPANOTOMY TO ALLOW VISUALIZATION OF THE ROUND WINDOW NICHE STEP 3 – PUNCTURE AND INCISION OF THE ROUND WINDOW MEMBRANE STEP 4 – APPROACH TO THE SCALA TYMPANI DIRECTLY THROUGH THE ROUND WINDOW MEMBRANE (PARTIAL INSERTION OF THE ELECTRODE ARRAY) STEP 5 – ELECTRODE FIXATION IN THE ROUND WINDOW NICHE WITH FIBRINE GLUE (MEMBRANE MUST BE PARTIALLY UNCOVERED TO PRESERVE ITS MOBILITY) STEP 6 – FIXATION OF THE DEVICE IN THE WELL IN TEMPORAL BONE Henryk Skarzynski. Cochlear Implantation. Left Ear The 8 th LION Global Broadcast May 16 th, 2013 LION TV CHANNEL 2 World Hearing Center of the Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany
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TYPE OF SURGERYCochlear implant surgery
PLANNED SURGERYMED EL Flex Soft cochlear implantationfor Partial Deafness Treatment (left ear)
SURGICAL TECHNIQUE6 steps Skarzynski Surgical Procedure– Round Window Approach
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL 2LION TV CHANNEL 2
SURGEON:HENRYK SKARZYNSKIWorld Hearing Center of the Institute of Physiology and Pathology of Hearing Warsaw/Kajetany (Poland)
World Hearing CenterWorld Hearing Centerof the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
CASE 1/2(09h15 – 10h15)
CLINICAL23 y.o. ladyprogressive sensory – neural hearing loss for 10 years, bilateral HA user for 7 years, for last 3 years – no benefit, bilateral tinnitus, no other complaints.
OTOSCOPY bilateral normal
CT-scanCT-scan no anomalies in anatomy
Henryk Skarzynski. Cochlear Implantation. Left Ear
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL 2LION TV CHANNEL 2World Hearing CenterWorld Hearing Center
of the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
6 STEPS SKARZYNSKI SURGICAL PROCEDURE6 STEPS SKARZYNSKI SURGICAL PROCEDURESTEP 1 – ANTROMASTOIDOTOMY
STEP 2 – POSTERIOR TYMPANOTOMY TO ALLOW VISUALIZATION OF THE ROUND WINDOW NICHE
STEP 3 – PUNCTURE AND INCISION OF THE ROUND WINDOW MEMBRANE
STEP 4 – APPROACH TO THE SCALA TYMPANI DIRECTLY THROUGH THE ROUND WINDOW MEMBRANE
(PARTIAL INSERTION OF THE ELECTRODE ARRAY)
STEP 5 – ELECTRODE FIXATION IN THE ROUND WINDOW NICHE WITH FIBRINE GLUE (MEMBRANE MUST BE PARTIALLY
UNCOVERED TO PRESERVE ITS MOBILITY)
STEP 6 – FIXATION OF THE DEVICE IN THE WELL IN TEMPORAL BONE
Henryk Skarzynski. Cochlear Implantation. Left Ear
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL 2LION TV CHANNEL 2World Hearing CenterWorld Hearing Center
of the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
PURE-TONE AUDIOMETRYRIGHT EAR LEFT EAR
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL 2LION TV CHANNEL 2World Hearing CenterWorld Hearing Center
of the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
Henryk Skarzynski. Cochlear Implantation. Left Ear
FREE FIELD SPEECH AUDIOMETRY
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL LION TV CHANNEL 22World Hearing CenterWorld Hearing Center
of the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
TYPE OF SURGERYSurgery for CSOM without cholesteatoma
PLANNED SURGERYExplorative tympanotomy with ossiculoplasty or stapedotomy (left ear)
SURGICAL TECHNIQUEIntracanal approach, possible glass-ionomeric cement use, or stapes prosthesis
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL LION TV CHANNEL 11
SURGEON:HENRYK SKARZYNSKIWorld Hearing Center of the Institute of Physiology and Pathology of Hearing Warsaw/Kajetany (Poland)
World Hearing CenterWorld Hearing Centerof the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
CASE 2/2(11h00 – 11h45)
CLINICAL25 years old man
with left ear hypoacussis for about 10 years, history of heard trauma in adolescence, no progression of hearing impairement, family history as for hypoaccussis non-contributory, no tinnitus, no vertigo.
OTOSCOPY Both sides – normal
Henryk Skarzynski. Ossiculoplasty. Left Ear
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL LION TV CHANNEL 11World Hearing CenterWorld Hearing Center
of the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
Henryk Skarzynski. Ossiculoplasty. Left Ear
The The 88thth LION Global Broadcast LION Global BroadcastMay May 1616thth, 201, 20133
LION TV CHANNEL LION TV CHANNEL 11World Hearing CenterWorld Hearing Center
of the of the InstituteInstitute of of Physiology Physiology andand Pathology Pathology of Hearing, Warsawof Hearing, Warsaw/Kajetany/Kajetany
PURE-TONE AUDIOMETRYRIGHT EAR LEFT EAR
