Surgical considerations

The restoration of sound perception with cochlear implantation is one of the more significant advances in medicine in the past 30 years. The bestowment of the 2013 Lasker-DeBakey Clinical Medical Research Award upon scientists Graeme Clarke, Ingeborg Hochmair, and Blake Wilson for their contributions to development of the modern cochlear implant has raised global awareness of the transformative nature of this remarkable technology (Roland and Tobey, Cell 154(6):1175-1177, 2013). The implant technology, processing strategies, and outcomes have significantly improved since the first generation of implants. Many of the basic surgical principles that were developed for cochlear implantation have held up over time. However, evolutions in technique to minimize the incision and enhance patient recovery, as well as newer electrode insertion techniques to enable preservation of cochlear structure and function have taken place. The techniques and principles of cochlear implant surgery are discussed in this chapter.