Combined local anesthesia and monitored anesthesia care for cochlear implantation - 19/08/14

Doi : 10.1016/j.anorl.2012.12.006

M. Alzahrani ^a,^b,^⁎ , F. Martin ^c, C. Bobillier ^a, A. Robier ^a, E. Lescanne ^a,^d
^a Service d’ORL et de chirurgie de la face et du cou, centre hospitalier universitaire de Tours, 37044 Tours cedex, France
^b King Fahd Specialist Hospital, ENT Department, 31491 Dammam, Saudi Arabia
^c Service d’anesthésiologie, centre hospitalier universitaire de Tours, 37044 Tours cedex, France
^d UMR Inserm U930, CNRS ERL 3106, université Francois-Rabelais de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France

^⁎Corresponding author. Service d’ORL et de chirurgie de la face et du cou, centre hospitalier universitaire de Tours, 37044 Tours cedex, France. Tel.: +33 2 47 47 38 87; fax: +33 2 47 47 36 00.

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Abstract

Introduction

Cochlear implantation has become a routine procedure for patients with hearing loss. In some patients, general anesthesia might be contraindicated due to multiple co-morbidities. We describe a successful protocol for cochlear implantation under local anesthesia with light sedation.

Case report

An 81-year-old patient presented with profound sensorineural hearing loss. Her past medical history revealed ischemic coronaropathy, managed by stenting. After multidisciplinary evaluation and clear adapted information to the patient, surgery was performed under local anesthesia with light sedation and monitored anesthesia care. The procedure lasted 70min, and was without incident and under good conditions for the surgeon. During the intervention, the patient was comfortable. No nausea or vomiting was noted. The postoperative period was smooth and uneventful.

Conclusion

We find local anesthesia with light sedation a good alternative to general anesthesia for patients where general anesthesia is contraindicated. An experienced surgical and anesthesiology team is essential to shorten the duration of the procedure.

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Keywords : Cochlear implantation, Local anesthesia with sedation, Hearing loss