Wundhaken mit integriertem Saugrohr und Lichtleiter für die Cochlear-Implant-Chirurgie[*]

Summary

Background: It is a general goal of the operative medicine to minimize the trauma of a surgical procedure in physical and psychical respect. This has led to the development of a minimally invasive surgery in cochlear implantation. The established supraaural "Hannover-skin incision" has been abandoned by many surgeons for just a retroauricular approach. However, the access for the surgeon is limited in drilling a bed for the implant body. This could cause difficulties in control of severe bleeding or management of a lesion of the dura which has regularly to be exposed in pediatric implantation.

Method: Basing on good experiences with an already existing suction wound retractor a novel instrument with a slim, 43 to 11 mm long blade with integrated suction and illumination has been developed. The end of the suction line has a distance of 18 mm to the end of the blade whereas the end of the fiberoptic is located 34 mm from this point. The instrument's weight is 100g.

Results: This instrument has proven to be useful in 15 consecutive cochlear implantations and guarantees a brightly illuminated operating field without bone dust or a surplus of water for irrigation. The handling of this instrument is ergonomic despite the two cables for the suction and illumination due to the centre of gravity in the middle of the retractor. All fingers can catch the broad grip, which enables an ergonomic work without exhaustion.

Conclusions: The newly developed instrument makes it easier and safer to drill out a bony bed for the implant. Thus an adequate compromise can be respected between minimization of the trauma and surgical accessibility.

1 Auszugweise vorgetragen auf der 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie in Erfurt

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1 Auszugweise vorgetragen auf der 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie in Erfurt