title: Comparison of two cochlear implantation techniques and their effects on the preservation of residual hearing. Is the surgical approach of any importance?
abstract: The goal of this work was to review the pre-and postsurgical auditory thresholds of two surgical implantation techniques, namely the mastoidectomy with posterior tympanotomy approach (MPTA) and suprameatal approach (SMA), to determine whether there is a difference in the degree of preservation of residual hearing. In a series of 430 consecutive implanted patients 227 patients had measurable pre-operative hearing thresholds at 250, 500, and 1,000 Hz. These patients were divided into two groups according to the surgical technique that was used for implantation. The SMA approach was followed for 84 patients in Amsterdam, whereas the MPTA technique was adhered to 143 patients in Maastricht. The outcome variables of interest were alteration of pre-and postoperative auditory thresholds after cochlear implantation. Complete or partial preservation of residual hearing was obtained in 21.4 and 21.7% in the SMA and MPTA group, respectively. No statistical differences could be found between the SMA and MPTA group (p = 0.96; Chi-square test). The SMA technique is correlated with a similar degree of hearing loss after cochlear implantation compared to the MPTA technique. However, both techniques were not able to conserve a measurable amount of hearing in patients with a substantial degree of residual hearing. Therefore, both surgical techniques need to be refined for patients in which residual acoustical hearing is pursued.
authors: Department of Otolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands, jobpostlemans@gmail.com.
authors: J T F
authors: JT
authors: Postelmans
authors: R J
authors: RJ
authors: Stokroos
authors: E
authors: E
authors: van Spronsen
authors: W
authors: W
authors: Grolman
authors: R A
authors: RA
authors: Tange
authors: M J
authors: MJ
authors: Maré
authors: Wouter Albert
authors: WA
authors: Dreschler
mesh_terms: D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology*; D019929:Cochlear Implantation / Q000379:methods*; D004567:Electrodes, Implanted; D006801:Humans; D011183:Postoperative Complications / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic
references: Otol Neurotol. 2010 Feb;31(2):196-203
references: 20009783
references: ORL J Otorhinolaryngol Relat Spec. 1997 Jan-Feb;59(1):23-35
references: 9104746
references: Otol Neurotol. 2004 Jan;25(1):41-4; discussion 44-5
references: 14724490
references: Acta Otolaryngol. 2005 May;125(5):481-91
references: 16092537
references: Laryngoscope. 2003 Oct;113(10):1726-30
references: 14520097
references: Otol Neurotol. 2006 Aug;27(5):624-33
references: 16868510
references: ORL J Otorhinolaryngol Relat Spec. 2002 Nov-Dec;64(6):406-12
references: 12499764
references: Eur Arch Otorhinolaryngol. 2007 Aug;264(8):855-60
references: 17333229
references: Ann Otol Rhinol Laryngol. 1976 May-Jun;85 suppl 27(3Pt2):1-93
references: 779582
references: Am J Otol. 1997 Mar;18(2):179-83
references: 9093674
references: Acta Otolaryngol. 2002 Oct;122(7):715-9
references: 12484647
references: Acta Otolaryngol. 2011 Sep;131(9):958-61
references: 21619439
references: Annu Rev Med. 2004;55:157-67
references: 14746514
references: Acta Otolaryngol. 2004 Apr;124(3):272-80
references: 15141755
references: Am J Otol. 1998 Sep;19(5):591-7
references: 9752966
references: Audiology. 1998 Nov-Dec;37(6):382-95
references: 9888194
references: Laryngoscope. 2005 May;115(5):796-802
references: 15867642
references: ORL J Otorhinolaryngol Relat Spec. 2002 Nov-Dec;64(6):413-6
references: 12499765
references: Laryngoscope. 2009 Aug;119(8):1571-8
references: 19507230
references: Acta Otolaryngol. 2004 May;124(4):348-52
references: 15224851
references: Otolaryngol Head Neck Surg. 2008 Sep;139(3):399-404
references: 18722221
references: Otol Neurotol. 2006 Dec;27(8):1083-8
references: 17130798
references: Otolaryngol Head Neck Surg. 2000 Oct;123(4):467-74
references: 11020188
references: Acta Otolaryngol. 2005 Aug;125(8):870-6
references: 16158535
references: Cochlear Implants Int. 2001 Sep;2(2):135-49
references: 18792095
references: Audiology. 1999 Mar-Apr;38(2):109-16
references: 10206520
references: Wien Klin Wochenschr. 2000 Jun 2;112(11):487-91
references: 10890126
references: J Laryngol Otol. 2008 Mar;122(3):246-52
references: 17666134
references: Laryngoscope. 2011 Aug;121(8):1794-9
references: 21792971
references: ORL J Otorhinolaryngol Relat Spec. 2002 Jul-Aug;64(4):247-53
references: 12232469