Round window electrode insertion potentiates retention in the scala tympani.
CONCLUSIONS
The round window membrane (RWM)-intentioned approach is superior to the traditional bony cochleostomy (BC) approach in obtaining electrode placement within the scala tympani (ST).


OBJECTIVE
Cochlear implant outcome is influenced by several factors, including optimal placement and retention of the electrode array within the ST. The present study aimed to assess whether the RWM route is superior to a traditional BC for placement and retention of the electrode array in the ST.


METHODS
This was a prospective consecutive non-randomized comparison study. All patients were implanted with the Advanced Bionics 1J electrode array. The RWM approach (n = 32) was compared with a traditional BC group (n = 33). The outcome measure was the electrode position as judged within the scalar chambers at four points along the basal turn using postoperative computed tomography (CT).


RESULTS
When the mean position scores were compared, the RWM-intentioned group had significantly more electrodes directed towards the ST compartment than the BC group (p < 0.001). The RWM electrodes achieved 94% ST retention compared with 64% for the BC group (p < 0.05). All electrodes stayed in the ST in the RWM group, whereas in the BC group 9% crossed from the ST to the scala vestibuli.
Department of Radiology, Guy's and St Thomas' Hospital, London, UK. sejconnor@gmail.com
Stephen E J
SE
Connor
N Julian
NJ
Holland
Andreas
A
Agger
Annabelle C
AC
Leong
Re Ajay
RA
Varghese
Dan
D
Jiang
Alec
A
Fitzgerald O'Connor
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D015331:Cohort Studies; D004567:Electrodes, Implanted; D019544:Equipment Failure Analysis; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods; D012405:Round Window, Ear / Q000000981:diagnostic imaging / Q000601:surgery*; D012533:Scala Tympani / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult