1. TYPE OF SURGERY: Cochlear implant surgery of a patient with VLA Syndrome PLANNED SURGERY: Med-El cochlear implantation (RIGHT EAR) SURGICAL TECHNIQUE Perilymph gusher is expected LION TV CHANNEL 2 CASE 1/1 (11h45 – 12h45) SURGEON: Caglar Batman Marmara Medical University Istanbul (Turkey) Marmara Medical University, Istanbul The 8 th LION Global Broadcast May 16 th, 2013

2. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul 16 years old, girl Clinical presentation : Progressive hearing loss Clinical follow-up: –Progressive hearing loss starting from second year of life –Several times she had had progression and remissions –She had very limited benefit from corticosteroids –She could not benefit from her hearing aids in the last 6 months The 8 th LION Global Broadcast May 16 th, 2013

3. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul The 8 th LION Global Broadcast May 16 th, 2013 Background: –Febrile illness (-) / Seizures (-) –Icterus (-) / Maternal febrile illness during pregnancy) (-) –Infection(-)/ Intermarriage (-) –Postlingual –Right-handed –Tonsillectomy + adenoidectomy ( 2 years old)

4. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul The 8 th LION Global Broadcast May 16 th, 2013 Audiometry:

5. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul The 8 th LION Global Broadcast May 16 th, 2013 Temporal CT and MR -Bilateral vestibular aqueduct enlargement (vestibular aquaduct syndrome) - Trajectory of facial nerve and vestibulocochlear nerve are regular - Morphology of vestibulum and semicircular canals are regular -Bilateral modiolus are smaller than normal size. This was considered as hypoplastic - Bulbous appearance of cochlea was considered as septation defect

6. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

7. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

8. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

9. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

10. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

11. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

12. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

13. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

14. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

15. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

16. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013

17. Caglar Batman. Cochlear Implantation. Right ear LION TV CHANNEL 2 Marmara Medical University, Istanbul LION TV2 – 4/44 The 8 th LION Global Broadcast May 16 th, 2013