My Surgical Report

Copied from MyChartTM, a wonderful service available through Sunnybrook Hospital.  

Note: For protection of privacy, all names and identifying information have been removed.

SERVICE DATE: 2013/APR/18
PREOPERATIVE DIAGNOSIS:
Deafness.
POSTOPERATIVE DIAGNOSIS:
Deafness.
PROCEDURE:
Right cochlear implantation (advanced Bionics Mid-Scala,) facial nerve monitoring, Palva musculoperiosteal flap, connective tissue obliteration of round window niche.
PROCEDURE:
The patient was identified and brought to the Operating Suite under general anesthesia with orotracheal intubation. She was positioned for surgery. The right retroauricular area was shaved, prepped, and draped in standard fashion. Facial nerve monitoring was established with bipolar electrodes. Eight millimeters of Xylocaine was injected into the postauricular skin.

A postauricular incision was made and set between retractions applied. A large musculoperiosteal Palva flap was developed for later use. A standard mastoidectomy was performed followed by a facial recess approach. The round window niche was exposed with a millimeter diamond burr. The round window membrane was fully exposed. Approximately 2 millimeters of Decadron was placed in the middle ear space. Following that, a bony recess was made in the posterior superior margin of the mastoid cavity to accommodate the receiver stimulator. This was done in standard fashion.

Under microscopy, a cochleostomy anterior and inferior to the round window was drilled. The receiver simulator of the implant was placed in the bony valve and secured to the skull with 2-0 Surgilene sutures. The electrode was irrigated with Decadron and a Foley inserted with the insertion device. The insertion went without problems up to the second blue marker ring. The electrode was curled within the mastoid cavity. A small amount of connective tissue was placed around the electrode at the level of the cochleostomy.

There was no adverse facial activity throughout the case.

Blood loss was minimal.

The patient was extubated and brought to the Recovery Room in excellent condition.

The wound was dressed in standard fashion with a head dressing.