, Vincent Y. W. Lin2 and Joseph M. Chen2
(1)
Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
(2)
Department of Otolaryngology Head & Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
Electronic supplementary material
Supplementary material is available in the online version of this chapter at 10.1007/978-3-7091-1490-2_5. Videos can also be accessed at http://www.springerimages.com/videos/978-3-7091-1489-6.
In the context of cochlear implantation, visualization of the round window is very important: first, if the electrode is inserted directly through the round window membrane, and second when a cochleostomy is performed, the round window serves as an important landmark.
For the inexperienced surgeon, a hypotympanic air cell can be mistaken for the round window and a faulty electrode insertion may occur (Fig. 5.2, left).To see the full extent of the membrane, the subject is tilted back from the slot position towards the surgeon. Sometimes, bone removal medial to the facial nerve is necessary to expose the round window (Fig. 5.1). The pseudomembrane which may be partially or fully covering the round window niche is removed using a Rosen needle, and the bony overhang (subiculum) is drilled away to visualize the membrane (Fig. 5.2).
