Endoscopic visualisation of the round window during cochlear implantation

BACKGROUND: Endoscopes provide a magnified view of the middle ear and visualisation of hidden areas. Otoendoscopes facilitate excellent visualisation of the round window niche during cochlear implantation. OBJECTIVE: To compare microscopic and endoscopic visualisation of the round window membrane during cochlear implantation in 20 patients. METHODS: Twenty patients who underwent cochlear implantation were included in the study. After maximum exposure of the round window, the accessibility of the round window membrane was graded according to the St Thomas Hospital classification, first by microscope and then by endoscope. RESULTS: With the use of the endoscope, visualisation of the round window membrane improved in all the patients as compared to the microscope. The electrode array was inserted via a round window or extended round window approach in all but two cases; the latter cases required bony cochleostomy because of unfavourable anatomy. CONCLUSION: The main benefit of endoscope-assisted cochlear implantation is improved visibility of the round window region.