title: Cochleostomy versus round window insertions: influence on functional outcomes in electric-acoustic stimulation of the auditory system.
abstract: OBJECTIVE
  To assess the potential influence of 2 different surgical access routes to scala tympani for hearing preservation cochlear implantation on outcomes.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Tertiary care academic center.
  
  
  METHODS
  Twenty adult subjects participating in a prospective clinical trial on electric-acoustic stimulation. Subjects underwent cochlear implantation with attempted hearing preservation and subsequent ipsilateral electric-acoustic stimulation of the auditory system.
  
  
  METHODS
  Eight subjects (40%) were implanted using a round window-related cochleostomy and 12 subjects (60%) via a round window approach.
  
  
  METHODS
  Postoperative acoustic hearing preservation and speech perception measures were obtained at defined intervals and compared for both groups with and without the use of the external speech processor.
  
  
  RESULTS
  The data demonstrate no statistically significant differences in postoperative outcomes for both preservation of residual hearing and unaided and aided speech perception between the cochleostomy and round window groups.
  
  
  CONCLUSIONS
  The results of this investigation suggest that hearing preservation cochlear implantation can be performed either via a round window-related cochleostomy as well as via the round window membrane itself with similar outcomes in terms of both hearing preservation rates as well as speech perception measures.
authors.affiliation: *Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill; and †Department of Audiology, UNC Healthcare, Chapel Hill, North Carolina, U.S.A.
authors.forename: Oliver F
authors.initials: OF
authors.lastname: Adunka
authors.forename: Margaret T
authors.initials: MT
authors.lastname: Dillon
authors.forename: Marcia C
authors.initials: MC
authors.lastname: Adunka
authors.forename: English R
authors.initials: ER
authors.lastname: King
authors.forename: Harold C
authors.initials: HC
authors.lastname: Pillsbury
authors.forename: Craig A
authors.initials: CA
authors.lastname: Buchman
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D003051:Cochlea / Q000601:surgery*; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004558:Electric Stimulation; D005260:Female; D006309:Hearing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012405:Round Window, Ear / Q000601:surgery*; D012533:Scala Tympani / Q000033:anatomy & histology / Q000601:surgery*; D013067:Speech Perception; D013068:Speech Production Measurement; D016896:Treatment Outcome; D055815:Young Adult