Foil Technique for Optimized Cosmetic Results in CI Surgery

Abstract

Objective: Cosmetic results in bilateral cochlear implantations strongly depend on the symmetric position of the coils, not only the scars. The primary purpose of this work is to present a simple method to find the correct position for the second coil and to ensure symmetry in single and 2-step implantation procedures.

Method: In a proof-of-principle study, 5 CI patients were supplied with a second CI. Important reference points were marked using a silicone foil. The foil then was transferred to the opposite side, and according to reference points, the exact symmetric position of the speech-processor coil could be located.

Results: Coil positions were measured postoperatively, and photographs were taken to evaluate success. In all patients, the second coil could be placed symmetrically to the opposite side. The location error is less then 5 mm, measured with the pre- or intraoperatively drawn transparency. The cosmetic outcome was associated with a high degree of patient satisfaction in all patients. Furthermore, silicone transparencies have excellent hygienic properties and are easily to sterilize.

Conclusion: The introduced silicone foil technique is easy and quickly implemented. Other intraoperative methods in coil positioning, such as those based on photography, are less accurate and depend highly on the surgeon’s capabilities. Especially in bilateral CI-surgery, silicone transparencies should become a standard technique for higher patient satisfaction and outstanding cosmetic results.