Surgery by Dr. Robert Briggs
En SurgSchool, the number one app for online surgical training, we present a new otological surgery narrated step by step by the Dr. Robert Briggs, an international leader in otology and cochlear implant surgery: “Cochlear implant with slim perimodiolar electrode”Dr. Robert Briggs is Medical Director of the Cochlear Implant Clinic at the Royal Victorian Eye and Ear Hospital and Clinical Professor in the Departments of Surgery and Otolaryngology at the University of Melbourne, Australia.
Surgical technique and anatomical considerations
The procedure shows the implantation of a slim perimodiolar electrode, designed for closer positioning to the modiolus and more efficient auditory stimulation. After the initial marking, Dr. Briggs makes a retroauricular incision and elevates a periosteal fibromuscular flap, exposing the mastoid through a wide mastoidectomy and approach through the facial recess.
During dissection, the facial nerve in its descending segment and chorda tympani, which are carefully preserved to optimize exposure of the round window niche. Additional bone is removed in the anteroinferior region of the facial nerve and lateral tympanic sinus until the true membrane of the round window, where a is created extended cochleostomy with fine diamond bur (0.8–1 mm).
A subperiosteal pocket is then made for the receptor-stimulator, with a channel towards the sinodural angle that allows a precise anatomical fit of the implant. The electrode is inserted through a insertion sheath following the anatomical orientation parallel to the descending facial nerve and perpendicular to the lateral semicircular canal, ensuring a stable path of the cable under the posterior bony ridge.
La final electrode position It is confirmed radiographically intraoperatively, and the cochleostomy is sealed with periosteal fragments before closure in layers.
Teaching and didactic value
This surgery offers invaluable educational material for otosurgeons and residents interested in cochlear implant techniques, highlighting the importance of anatomical control, neural preservation, and proper insertion of the perimodiolar electrode.
The video is narrated in English, with Spanish dubbing available on the app, and is part of the growing collection of Advanced otologic surgeries available in SurgSchool, the leading platform in audiovisual surgical education for specialists from all over the world.
