title: The suprameatal approach: a safe alternative surgical technique for cochlear implantation.
abstract: OBJECTIVE
  To report on surgical complications arising postoperatively in 104 patients undergoing cochlear implantation surgery using the suprameatal approach (SMA). Second, to examine the advantages and disadvantages of the SMA technique compared with the classic mastoidectomy using the posterior tympanotomy approach.
  
  
  METHODS
  Retrospective study assessing surgical complications in deaf adults and children undergoing cochlear implantation.
  
  
  METHODS
  Tertiary referral center for cochlear implantation (Academic Medical Centre).
  
  
  METHODS
  The mean age at the time of surgery was 39.6 years (1.0-82.3 yr), and the mean duration of deafness was 26.3 years (0.3-66.0 yr). The main cause was a congenital hearing loss (30.8%) and a progressive sensorineural hearing loss e.c.i. (25.0%), followed by meningitis (12.5%) and otosclerosis (6.7%). The mean duration of follow-up after surgery was 25.7 months (range, 3.0-59.0 mo).
  
  
  RESULTS
  The overall major complication rate was 3.7% (4 of 107). All complications developed postoperatively. The major complications consisted of extrusion of the implant due to wound infection (n = 2), a wrong route for the electrode (n = 1), and device failure (n = 1). The minor complication rate was 23.4% (25 of 107). The mean time taken for cochlear implantation was 111.7 minutes (range, 60.0-261.1 min).
  
  
  CONCLUSIONS
  This study confirms the SMA is a safe, simple, and quick technique that is feasible for cochlear implantation in most cases. Although the stretching of the electrode array when it enters the scala tympani and a low-lying dura could present a potential restriction for the SMA technique, our results do not support this hypothesis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Job T F
authors.initials: JT
authors.lastname: Postelmans
authors.forename: Rinze A
authors.initials: RA
authors.lastname: Tange
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stokroos
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000033:anatomy & histology / Q000601:surgery; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D003054:Cochlear Implants; D003638:Deafness / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000473:pathology; D055815:Young Adult