Surgery for Cochlear and Other Auditory Implants

Review by A Banerjee

I was delighted to be asked to review this book, as most books authored or edited by Mario Sanna’s group show a fantastic collection of beautifully dissected temporal bones, to demonstrate both anatomy and surgical technique. This book does not disappoint.

It is divided into sections that deal with implantation, with case studies interspersed within them, and videos demonstrating the techniques. Let me start by telling you what I don’t like, because there is much to like in this book. The online video section leaves a lot to be desired. It consists of a poorly edited collection of cochlear implant surgery videos, with little or no commentary. I am fairly sure that my 10-year-old daughter is better able to edit videos, using simple editing software, though, in the publisher’s defence, my daughter does have her own YouTube channel!

The initial chapters of the book cover the history, anatomy, radiology and instruments. The sections are adequate, without being too long. The dissections, demonstrating the surgical anatomy, are top class as always. I particularly like the step-by-step sequences of computed tomography scans, which will be of use to the initiate trying to plan a cochlear implant procedure. A more detailed section on abnormal anatomy and the possible complications that may be encountered would have been useful, though some of these issues are covered in subsequent sections.

The next three chapters cover implantation, with special consideration of paediatric patients and revision surgery. The basic surgical steps are covered adequately. A more detailed discussion about the position of the cochleostomy and the management of variations would help the novice surgeon. I liked the technique used to achieve symmetrical positioning in bilateral surgery. Some of the cases discussed in the complications section were interesting; I hope never to see an electrode array in the carotid canal!

There are a couple of chapters on auditory brainstem implantation and electroacoustic stimulation. Technique for Hearing Preservation Surgery will need to be expanded in subsequent editions of this book.

The parts of the book I enjoyed most were the chapters on cochlear implantation in the difficult patient. The chapters cover conditions like cochlear ossification, meningitis, otosclerosis, post-mastoiditis and malformations. The chapter on subtotal petrosectomy has some beautiful photographs demonstrating the technique of blind sac closure of the external auditory canal, which can be used as a surgical manual. There is, similarly, a wonderfully illustrated section of a round window drill-out in cochlear obliteration. I like the decision-making algorithm in patients with meningitis and advanced otosclerosis. It would be difficult to discuss each chapter individually in more detail, but there is much to commend them. My only regret is that these techniques could have been far better demonstrated in videos which could accompany this book.

The sections on bone conduction aids and active middle-ear implants are basic. I would do away with these, as they do not add much to the book and merit a separate volume in themselves.

This book has a lot to commend it, both for the novice and experienced surgeon. The basics are well covered, but I hope that future editions will have better-edited videos. Cochlear implantation surgery is rapidly evolving; I look forward to a newer edition that will incorporate these changes.

Amazon Link: Surgery for Cochlear and Other Auditory Implants
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