Hearing loss isn't always treatable with medication or hearing aids alone. In certain circumstances, an ENT doctor may consider surgery for severe and potentially life-threatening cases of hearing loss and inner ear issues , including procedures involving the cochlea, better known as the cochlea . Access to the cochlea is achieved through a cochleostomy .
For some, this term may sound unfamiliar. In fact, a cochleostomy is a procedure performed to create access, or a small opening, to the cochlea so that a doctor can perform certain procedures on the inner ear.
What is a Cochleostomy?
Medically, a cochleostomy is a surgical procedure that involves creating an opening in a specific part of the cochlea to gain access to the space inside the cochlea.
The cochlea is a snail-shaped structure located in the inner ear. It contains sensory cells that convert the mechanical energy of sound into electrical signals, which are then transmitted via the auditory nerve to the brain.
Why Do Doctors Need to Create Access to the Cochlea?
Access to the cochlea may be necessary for certain medical conditions or procedures. One known use is as a pathway for inserting electrodes during cochlear implant surgery .
However, it's important to understand that not every cochleostomy will result in a cochlear implant . Decisions regarding the procedure's technique and goals will depend on the patient's diagnosis and ear condition.
How is a Cochleostomy Procedure Performed?
The procedure is performed by an ENT Head and Neck Surgery Specialist using microsurgical techniques using special instruments.
Generally, the doctor will access the middle ear until he reaches the cochlea. Once the exact location is determined, a small opening is made in the cochlea to meet the procedure's objectives.
If a cochleostomy is performed as part of cochlear implant surgery, the access can then be used to insert electrodes into the cochlea.
Surgical techniques can vary from patient to patient, including the choice of access site and electrode placement method. The doctor will determine the technique based on the ear anatomy, hearing condition, and patient needs.
Is a Cochleostomy the Same as a Cochlear Implant?
Cochleostomy is a procedure to create access to the cochlea , while a cochlear implant is an electronic device used to help provide auditory stimulation to patients who meet the criteria.
The two can be related because cochleostomy can be one of the routes used in the installation of a cochlear implant.
Does All Hearing Loss Require a Cochleostomy?
No. Cochleostomy is a special procedure for the inner ear which is only performed if there is a clear medical indication .
Patients with hearing loss need to undergo an initial examination to determine the type and degree of their hearing loss. Doctors may perform a hearing test and other supporting tests before determining whether surgery is necessary.
Don't Determine the Type of Operation Yourself
Hearing loss has many causes, and not all require surgery. If hearing aids no longer provide optimal benefit or if there is severe hearing loss, further evaluation is recommended.
Consult your hearing condition with an ENT Head and Neck Surgery Specialist to find out the appropriate diagnosis and treatment options.
In the next series, we will learn more about cochlear implants , which are devices that can be installed in the cochlea to help patients with certain hearing disorders.
Article written by Dr. Eko Teguh P, Sp.THT-KL (Ear, Nose, Throat Specialist – Head and Neck Surgery, EMC Alam Sutera Hospital).