A New Surgical Approach for Direct Acoustic Cochlear Implant: A Temporal Bone Study

OBJECTIVES The direct acoustic cochlear implant (DACI) is among the latest developments in the field of implantable acoustic prostheses. The surgical procedure requires a mastoidectomy and a posterior-inferior tympanotomy, with access to the facial recess at the level of the oval window, in a complex and lengthy surgical approach. Here, we report a new and considerably shorter surgical approach. METHODS The new approach involves positioning of artificial incus above the oval window through the superior-anterior tympanotomy. We performed DACI placement in temporal bone specimens (n=5) to assess the feasibility of the new approach. RESULTS The average time for the DACI implant in the temporal bones was only 112 minutes (range, 94 to 142 minutes) and there was little clinical risk associated with the procedure. Access was easy and drilling was minimal. CONCLUSION Our approach simplified the surgical procedure and consequently reduced the time required for DACI placement.