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[Comparative analysis of surgical approaches used during intracochlear implantation with reference to their safety for the important structures of the temporal bone].

A comparative analysis was made of three operative approaches used in cochlear implantations, regarding their safety for main structures of the temporal bone, simplicity and versatility. Anatomical and clinical data from literature were worked out. It was stated that the posterior tympanotomy approach is best because of its allows for good view on the round window niche and its risk for the facial nerve damage is not greater than that of the other routes. The posterior tympanotomy approach is safe for small children because the space between the facial nerve and tympanic ring is not smaller in them than in adults. This route to the tympanic cavity creates also possibilities for widening of the operating area if it is necessary, for example in obstructed and obliterated cochleas. The anterior tympanotomy approach is dangerous for children because of a great risk for facial nerve and jugular bulb. The mastoidotomy-tympanotomy approach is on the other hand very complex, requires special equipment and is not more protective for the facial nerve than posterior tympanotomy approach.