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Pete's bar: alternative use of the laryngoscopy suspension bar to improve surgical exposure during small incision cochlear implantation

  • S A C MacKeith (a1), P Sleeman-Barker (a1) and J D Ramsden (a1)



Cochlear implant surgery is increasingly being performed through a small incision because of the benefits associated with this technique, such as fewer wound complications. Efforts have been made to maximise surgical exposure in order to improve this evolving technique; this includes the development and use of new retractors. For instance, elasticated stay hooks can retract skin in a radial fashion and they are less bulky than traditional retractors. These hooks are usually attached directly to surgical drapes or to a disposable retractor ring; there are disadvantages to both of these methods.


This paper describes a technique using a laryngeal suspension bar in which the bar acts as a fixed structure to which these elasticated stay hooks can be attached.


This technique was found to be safer, cheaper and more effective for obtaining optimal surgical exposure compared with a technique whereby the stay hooks are attached directly to the drapes or to a disposable retractor ring.


Corresponding author

Address for correspondence: Mr S MacKeith, Department of ENT, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK E-mail:


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2O'Donoghue, GM, Nikolopoulos, TP. Minimal access surgery for pediatric cochlear implantation. Otol Neurotol 2002;23:891–4
3Ray, J, Gibson, W, Sanli, H. Surgical complications of 844 consecutive cochlear implantations and observations on large versus small incisions. Cochlear Implants Int 2004;5:8795
4Obholzer, RJ, Graham, JM. A novel retractor for use in cochlear implantation. Otol Neurotol 2003;24:749–50
5James, AL, Papsin, BC. Device fixation and small incision access for pediatric cochlear implants. Int J Pediatr Otorhinolaryngol 2004;68:1017–22
6Monksfield, P, Proops, D. A new retractor for cochlear implantation. Cochlear Implants Int 2008;9:61–3



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