Intra-operative radiological diagnosis of a tip roll-over electrode array displacement using fluoroscopy, when electrophysiological testing is normal: the importance of both techniques in cochlear implant surgery.

Abstract

Presently cochlear implantation (CI) is a worldwide well-known procedure for the treatment of severe to profound hearing loss.1 New surgical techniques and technological upgrades in the past years have helped to decrease complications of this procedure, but they still exist, defying experienced surgeons and device manufacturers. Major complications are defined as events that need surgical intervention with reimplantation, such as wound infections, device extrusions, device failure and electrode misplacement.2 The incidence of electrode misplacement fluctuates between 0.2% and 5.8%, including both extracochlear and labyrinthine misplacements.3 Despite the many described ways to ensure proper electrode array positioning, there is no universally accepted protocol for intraoperative monitoring during cochlear implantation. We present a case of an intracochlear array misplacement (tip rollover) that was diagnosed intraoperatively with a fluoroscope after normal electrophysiological tests.