title: Comparison of complications of the suprameatal approach and mastoidectomy with posterior tympanotomy approach in cochlear implantation: a meta-analysis.
abstract: BACKGROUND
  Cochlear implantation (CI) is a popular procedure to preserve hearing in patients with severe-to-profound hearing loss. Evidence shows that the suprameatal approach (SMA) may help reducing the risk of the incidence of complications and shortening the surgery time, but there is still dispute.
  
  
  OBJECTIVE
  The aim of this study was to compare the incidence of complications of SMA and the mastoidectomy with posterior tympanotomy approach (MPTA), and to find whether SMA yields better outcomes than MPTA.
  
  
  METHODS
  We searched PubMed, the Cochrane Library, the Web of Science and Chinese Biomedical Literature databases, Chinese National Knowledge Infrastructure, the Chinese Science and Technology Journal Full-Text database, and Wangfang database. The latest data was accessed in March 2013. Review Manager 5.1 software was used for comprehensive quantification data analysis.
  
  
  RESULTS
  Three studies were included in the meta-analysis, composed of 799 participants and reporting major and minor complications. The meta-analysis indicated no statistically significant difference in major and minor complications between the two approaches, except for facial nerve and chorda tympani injuries (OR = 0.13; 95% CI: 0.02, 0.67; p = 0.02; I(2) = 0%).
  
  
  CONCLUSIONS
  Current evidence suggests that SMA may be clearly a good alternative to the classical surgery technique for CI in terms of reducing the incidence of facial nerve injury and chorda tympani sacrifice.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Bai-Cheng
authors.initials: BC
authors.lastname: Xu
authors.forename: Su-Yang
authors.initials: SY
authors.lastname: Wang
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Liu
authors.forename: Ke-Hu
authors.initials: KH
authors.lastname: Yang
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Zhu
authors.forename: Xing-Jian
authors.initials: XJ
authors.lastname: Chen
authors.forename: Wan
authors.initials: W
authors.lastname: Du
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.forename: Chi
authors.initials: C
authors.lastname: Chen
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Guo
mesh_terms: D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D008416:Mastoid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D014432:Tympanic Membrane / Q000601:surgery*