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Background and Objectives@#With the introduction of sialendoscopy, minimal invasive surgery has become possible for the removal of sialoliths, although sialendoscopic removal of parotid stones remains a surgical challenge. Sialendoscopic stone removal can be differently applied according to the location and size of stones. This study was conducted to evaluate the surgical outcomes of sialaendoscopic stone removal and to provide a strategy for choosing an adequate surgical approach according to the characteristics of parotid stones.Subjects and Method A retrospective study was conducted of 43 patients with parotid sialolithiasis who were treated by sialendoscopic stone removal between March 2017 and January 2021. Surgical techniques were classified into sialendoscopy alone (SA), sialendoscopy-assisted transoral approach (STO), and sialendoscopy-combined retroauricular approach (SRA). The parotid gland stones were categorized by size, location, and multiplicity. @*Results@#Of the 43 patients, 13 patients underwent SA, 10 received STO, and 20 were treated with different SRA approaches. The SRA approaches included three distal, seven proximal, and ten intraglandular stone removal cases. The success rate of stone removal was 92% (12 cases) by SA, 90% (9 cases) by STO, and 100% (20 cases) by SRA. In cases of SA and STO, all patients had distant stones except for one who had proximal stones. Postoperative complications including pain, swelling, wound dehiscence, sialocele, duct stricture, and facial palsy mainly occurred in cases treated with SRAs. @*Conclusion@#Appropriate use of various sialendoscopy-assisted approaches is mandatory to preserve the gland and minimize surgical complications in patients with different features of parotid gland stones.
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Objectives@#. Common cavity deformity is a rare congenital bony labyrinth malformation associated with profound hearing loss. Cochlear implants are widely used for hearing rehabilitation for common cavity deformities; however, the reported prognosis is poor. Due to the deformed anatomical structure, it is important to consider the position of the electrodes to maximize the performance of the cochlear implant. The present study discusses the impact of electrode placement on hearing outcomes. @*Methods@#. A retrospective medical chart review of eight common cavity deformity patients (10 cochlear implants) who received cochlear implants was performed at a single university hospital. In all eight patients, implant surgery was performed using single-slit labyrinthotomy. Electrodes wer e manually bent before insertion to prevent misplacement and to reduce physical damage to the neuroepithelium. @*Results@#. Four of the 10 electrodes were misplaced, with their tips placed in the anterior semicircular canal or internal auditory canal. However, after implant surgery, all patients—including those with misplaced electrodes—gained auditory perception and improved hearing function. One patient who had electrodes that did not contact the inner wall of the cavity showed limited activity of the electrodes (27%) compared to others (64%–100%). @*Conclusion@#. Proper contact of the electrode with the inner wall was more likely to be important for cochlear implant success in cases of common cavity deformity than appropriate placement of the electrode tip.