Editors
Ing Ping Tang MD MS(ORL-HNS)
Otologist, Neurotologist and Skull Base Surgeon Department of Otorhinolaryngology, Faculty of Medicine University Malaysia Sarawak,
Sarawak, Malaysia
Philip Rajan Devesahayam MBBS MS(ORL-HNS) FRCS (Glasg)
Otologist and Neurotologist, Department of Otorhinolaryngology Hospital Raja Permaisuri Bainun,
Ipoh, Perak, Malaysia
Prepageran Narayanan MBBS MS(ORL-HNS) FRCS(Ed)
Professor, Otologist, Neurotologist and Skull Base Surgeon Department of Otorhinolaryngology, Faculty of Medicine University of Malaya,
Kuala Lumpur, Malaysia
Foreword
Professor Dato’ Dr Mohd Amin Jalaludin
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The Surgical Manual of Common Otological Implants
First Edition: 2015
9789351528586
Printed at
5Dedicated to
All my teachers and students: past, present and future, who are the inspiring force to produce this book.6
7Foreword
It gives me great pleasure to write a few words in conjunction with the publication of The Surgical Manual of Common Otological Implants. Otological implants have been a rapidly growing field in ORL-HNS with less than 20 years history in Malaysia. Currently, patients with any degree or type of hearing loss will have better alternatives if hearing aids are not suitable. However, specific indications need to be fulfilled before embarking on implantations for any patients. More specific training is required to master the surgical techniques in otological implantation.
I am delighted that University of Malaya Medical Centre is one of the pioneer hospitals in starting the otological implantation program in Malaysia. I would like to take this opportunity to congratulate Professor Dr Ing Ping Tang, Dr Philip Rajan Devesahayam and Dr Prepageran Narayanan for their full effort and team spirit during data collection, and photo compilation and writing process prior to publication of this book.
Therefore, I would like to recommend this book to intermediate level of otology trainees, otologists, ORL-HNS postgraduates and anyone who is interested in having better understanding of otological implants.
Professor Dato’ Dr Mohd Amin Jalaludin
Vice Chancellor
9Preface
This book demonstrates the surgical steps of common otological implants. The surgical steps are described by pictures.
This book would be useful for intermediate level of otology trainees, otologists or anyone who is interested in having better understanding of otological implants.
As this is demonstration of surgical steps of straightforward and uncomplicated otological implants, we will collect and describe more on complicated cases in the next edition.
Ing Ping Tang
Philip Rajan Devesahayam
11Acknowledgments
We gratefully acknowledge:
- Teachers, past and present, without whom, this work would not have been possible.
- Colleagues and students for their support.
- MED-EL Education grant.
Once upon a time, conventional hearing aids were the first line treatment and the only option for patients with hearing impairment. However, despite advances in hearing aid technology, there is still a significant group of patients in whom hearing aids are not suitable. These may be due to dissatisfaction of patient in term of cosmetic issues, impacted earwax, external ear infection, improper fitting or programming, occlusion and feedback effects.
In recent years, with the advancement of technology in instrumentation, otological implant has been a rapidly growing field both in children and adults. These devices consist of cochlear implant (CI), middle ear implant: Vibrant SoundBridge (VSB) and osseointegrated bone implant: BoneBridge (BB) and Bone anchored hearing aid (BAHA).
Otological implants do not end at surgery per se. Further rehabilitation after the surgery is crucial to achieve the maximum benefits of otological implants. Specifically, intensive rehabilitation in children with cochlear implants, either prelingual or postlingual, is of great importance to avoid compromising the development of language, speech and social skills.
In this pictorial manual, we will demonstrate the surgical steps of common otological implants in Malaysia, which we have performed, with the aim of helping intermediate level otology trainees or otologists to reproduce these maneuvers easily. Of course, further training with experienced otologists is needed to master these implantation techniques.
The procedures of the following otological implants will be demonstrated in this booklet:
- Cochlear implant (CI)
- Vibrant SoundBridge (VSB)
- BoneBridge (BB)
- Bone anchored hearing aid (BAHA)