title: Comparison of two approaches to the surgical management of cochlear implantation.
abstract: OBJECTIVE
  Our study was designed to compare two surgical approaches that are currently employed in cochlear implantation.
  
  
  METHODS
  There were 315 patients who were divided into two groups according to the surgical technique used for implantation. The suprameatal approach (SMA) was followed for 104 patients (107 implantations) in Amsterdam, whereas the mastoidectomy with posterior tympanotomy approach (MPTA) was adhered to for 211 (214 implantations) in Maastricht. The outcome variables of interest were duration of surgery and peri- or postoperative complications.
  
  
  RESULTS
  In the SMA group the incidence of major and minor complications was 3.7% (4/107) and 23.4% (25/107), respectively, whereas it was 6.5% (14/214) and 22.4% (48/214), respectively, in the MPTA group. A chi-square statistic of 1.096 (P = .295) and 0.021 (P = .884) for minor and major complications, respectively, indicated no statistically significant differences between the two techniques. Mean duration of surgery was significantly shorter (P < .0005) in the SMA (111.7 minutes) than in the MPTA (132.2 minutes) group.
  
  
  CONCLUSIONS
  The suprameatal approach is clearly a good alternative to the classical surgery technique for cochlear implantation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Maastricht University Medical Center, the Netherlands. jobpostelmans@gmail.com
authors.forename: Job T F
authors.initials: JT
authors.lastname: Postelmans
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
authors.forename: Rinze A
authors.initials: RA
authors.lastname: Tange
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stokroos
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D003054:Cochlear Implants; D007758:Ear, Inner / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008416:Mastoid / Q000601:surgery*; D016343:Monitoring, Intraoperative / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*; D055815:Young Adult