Extra-Cochlear Insertion in Cochlear Implantation: A Potentially Disastrous Condition

OBJECTIVES: Cochlear implantation is an increasingly used technique for auditory rehabilitation of pediatric and adult population. Safe implantation is achieved in most cases; however, intraoperative complications and misplacement of the electrode are observed in some. The aim of this presentation was to review the characteristics of patients with extra-cochlear electrode insertion, postoperative diagnostic methods, and considerations in revision surgery. MATERIALS AND METHODS: In total, 423 cases of cochlear implantation performed in our clinic between 2012 and 2018 were retrospectively analyzed and those of extra-cochlear implantation were evaluated. RESULTS: Extra-cochlear insertion was found in 3 patients. The electrode was placed into the internal acoustic canal in the first case, superior semicircular canal in the second case, and internal carotid artery canal in the third case. Cochlear insertion was achieved in all cases with re-implantation, and no complication was observed. CONCLUSION: This case series highlights that rare, but potentially serious, consequences of misplacement of the electrode in cochlear implantation can be successfully avoided and treated via a multidisciplinary approach.