In this lecture, we will see how to prepare the patient from the start of the surgery. Starting with positioning on the operating table, considering the measurements of the surgical field, skin incision, and muscle flap, as well as the creation of a subperiosteal pocket that perfectly accommodates the receiver-stimulator.

This lecture is focused on all the bone work on the mastoid to establish access, identifying the key limits of the approach prior to the posterior tympanotomy.

In this class, we will see how to adequately, broadly, and safely create a posterior tympanotomy approach that allows maximum exposure of the retrotympanum area, the tympanic and mastoid facial nerve, as well as a perfect visualization of the round window in its entirety.

The exposure and control of the round window are fundamental for the adequate insertion of the electrode. In this class, we will be able to see how to eliminate the round window niche to obtain complete exposure of the membrane. We will also see the internal anatomy of the cochlea, such as the tympanic and vestibular ramps, which will allow for proper placement of the electrode.

In this lesson, we will see how to make the process of inserting the electrode lead an atraumatic, comfortable, and safe act that gives the surgeon certainty of being in the correct place, as well as enabling appropriate manipulation of the implant. All of the above is to minimize trauma and thus achieve its best long-term function. We will provide guidelines with practical examples that are usually not provided in academic texts and are only acquired through personal experience, which is reflected in this lesson.

Despite all the precautions we take and an excellent surgical technique, difficulties will always appear along the way. This lecture seeks to expose you to the vast majority of them and equip you with the knowledge and practical examples of how to solve them.

Meniere’s disease is a very challenging pathology for the Otologist and Ear Surgeon, who must be equipped with all the tools to eliminate vertigo crises and restore hearing in the patient with a disabling disease, refractory to medical treatment. When facing a labyrinthectomy with simultaneous cochlear implant insertion, we must manage certain key anatomical considerations in relation to the cochlea and the facial nerve, as well as a perfect command of the structures of the posterior labyrinth. In this lecture, we will see the key references with clear examples to provide solutions for our patients.

Complete surgical cases.