title: Suprameatal approach for cochlear implantation in children: our experience with 320 cases.
abstract: OBJECTIVE
  To summarize our experience with the 320 children who underwent cochlear implantation by the suprameatal approach (SMA).
  
  
  METHODS
  The SMA involves entering the middle ear by retroauricular tympanotomy. After drilling of the cochleostomy and of the suprameatal tunnel, the electrode is passed through the suprameatal tunnel underneath to the chorda tympani and lateral to the incus into the cochleostomy.
  
  
  RESULTS
  The following implant-related complications required explantation with subsequent reimplantation: foreign body reaction (0.6%), allergy to implant (0.3%), and protrusion of the positioner (0.3%). Post-traumatically displaced magnets were reinserted in 3 (0.9%) children. All the vestibular (5.3%) and wound (3.1%) problems were considered as being patient-related and resolved spontaneously or were managed conservatively. There were no surgery-related complications and no cases of mastoiditis developed among the children implanted with the SMA.
  
  
  CONCLUSIONS
  The SMA enables a decreasing the rate of surgery-related complications and safe electrode insertion.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel. migirovl@gmail.com
authors.forename: Lela
authors.initials: L
authors.lastname: Migirov
authors.forename: Elad
authors.initials: E
authors.lastname: Dagan
authors.forename: Jona
authors.initials: J
authors.lastname: Kronenberg
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000601:surgery*; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D003054:Cochlear Implants; D015331:Cohort Studies; D003638:Deafness / Q000151:congenital / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome