CSF Gusher and Its Management in Cochlear Implant Patient with Enlarged Vestibular Aqueduct

  • Vaidik Mayurkumar Chauhan
  • Rajesh VishwakarmaEmail author
Original Article


Aim is to share our experience of CSF gusher and its management during cochlear implant surgery in patients with enlarged vestibular aqueduct. All cases underwent classic cochlear implant surgeries via Veria technique. It is a retrospective study done at Civil Hospital Ahmedabad from January 2013 to March 2018 with 415 patients. The study includes 39 children between age groups 2–8 years who have enlarged vestibular aqueduct. In all 39 patients with enlarged vestibular aqueduct during cochleostomy there was CSF gusher which was managed by the covering the cochleostomy site with temporalis fascia. There was no need for use of fibrin glue in any case. But it was kept in standby mode in case needed. And there was no post operative CSF otorrea in any patients. While preparing the patient for cochlear implant whenever you come across enlarged vestibular aqueduct via HRCT temporal bone and MRI of cochlea, be prepared for CSF gusher while doing the cochleostomy. Csf gusher is intra operative challenge rather than a bad prognostic determine for post operative audiologic out come. Keeping fibrin glue in stand by helps if major CSF leaks happens. Finally, we achieved a simple stepwise algorithm for the management of gusher during cochlear implantation.


Enlarged vestibular aqueduct Fibrin glue Temporalis fascia Veria technique 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participant were in accordance with the ethical standard.


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Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  • Vaidik Mayurkumar Chauhan
    • 1
  • Rajesh Vishwakarma
    • 1
    Email author
  1. 1.Department of ENT and Head and Neck SurgeryB.J. Medical College, Civil HospitalAhmedabadIndia

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