| Title: |
Vestibular Implant Surgery:How to Deal With Obstructed Semicircular Canals-A Diagnostic and Surgical Guide |
| Authors: |
van de Berg, Raymond; Stultiens, Joost Johannes Antonius; van Hoof, Marc; Van Rompaey, Vincent; Hof, Janke Roelofke; Vermorken, Bernd Lode; Volpe, Benjamin; Devocht, Elke Maria Johanna; Fornos, Angelica Perez; Postma, Alida Annechien; Lenoir, Vincent; Becker, Minerva; Guinand, Nils |
| Source: |
van de Berg, R, Stultiens, J J A, van Hoof, M, Van Rompaey, V, Hof, J R, Vermorken, B L, Volpe, B, Devocht, E M J, Fornos, A P, Postma, A A, Lenoir, V, Becker, M & Guinand, N 2025, 'Vestibular Implant Surgery : How to Deal With Obstructed Semicircular Canals-A Diagnostic and Surgical Guide', Journal of Otolaryngology-Head & Neck Surgery, vol. 54. https://doi.org/10.1177/19160216241291809 |
| Publication Year: |
2025 |
| Collection: |
Maastricht University Research Publications |
| Subject Terms: |
vestibular function; vestibular implant; vestibular implantation; vestibular prosthesis; implanted electrodes; semicircular canals; extracellular matrix proteins; fibrosis; ossification; magnetic resonance imaging; computed tomography; surgical procedures; ELECTRICAL-STIMULATION; COCH-MUTATION; EYE-MOVEMENTS; INNER-EAR; HEARING; DFNA9; CRITERIA |
| Description: |
Background A vestibular implant can partially restore vestibular function by providing motion information through implanted electrodes. During vestibular implantation, various obstructions of the semicircular canals, such as protein deposits, fibrosis, and ossification, can be encountered. The objective was to explore the relationship between preoperative imaging and intraoperative findings of semicircular canal obstruction and to develop surgical strategies for dealing with obstructions of the semicircular canal(s) in patients eligible for vestibular implantation.Methods Patients undergoing vestibulocochlear implantation (in an active clinical trial) were included in the current study when preoperative imaging indicated an obstruction in the semicircular canal. Preoperative imaging consisted of CT and MRI scans. During surgery, the bony semicircular canals were skeletonized ("bluelined") to identify the course of the canals and create a fenestration to insert the electrodes. The aim was to place the electrodes in the semicircular canal ampullae. Surgical strategies were developed to deal with the soft tissue obstructions. These procedures were evaluated intraoperatively with microscopic visualization, postoperatively with CT imaging.Results The three included patients suffered from bilateral vestibulopathy and hearing loss due to autosomal dominant nonsyndromic sensorineural deafness 9 (DFNA9). A soft tissue obstruction was predicted in one semicircular canal (2 patients) or two semicircular canals (1 patient), based on preoperative imaging. Intraoperatively, bluelining the semicircular canals aided in identifying these locations, by revealing a "whiteline" instead of blueline. Depending on the nature and location of the obstruction, different surgical procedures were employed to facilitate proper electrode insertion. These were as follows: a dummy electrode was used to probe the soft tissue, the obstructive tissue was removed, and/or a bypass fenestration was created. In all patients, the electrodes could be ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
1916-0216 |
| Relation: |
info:eu-repo/semantics/altIdentifier/wos/001387317400001; info:eu-repo/semantics/altIdentifier/pissn/1916-0216 |
| DOI: |
10.1177/19160216241291809 |
| Availability: |
https://cris.maastrichtuniversity.nl/en/publications/13896e99-7edd-489c-a881-f3c6004675e7; https://doi.org/10.1177/19160216241291809 |
| Rights: |
info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.38DE3D5B |
| Database: |
BASE |