Minimal access and standard cochlear implantation: A comparative study

Objective: To compare the operative times and complications between patients who underwent minimal access cochlear implantation and standard technique cochlear implantation. Methods: Patients who underwent unilateral cochlear implantation by a single surgeon from 2001 to 2010. The minimal access technique of an approximately 2.5-3 cm post-auricular incision with creation of subperiosteal pocket for the device was compared to the longer standard "S' incision into the scalp (similar to 8-10 cm) with bone well creation and suture fixation. Outcomes include operative times and complications. Results: There were 122 unilateral implants, 73(59.8%) in the minimal access group and 49(40.2%) in the standard group. Mean total time in the operating room was lower in the minimal access group compared to the standard group (200 +/- 31 vs. 255 +/- 49 min, p < .0001) as well as mean operative time (149.5 +/- 28 vs. 200 +/- 45 min, p < .0001 respectively). There were 17 complications in the entire cohort with 8 and 9 complications in the minimal and standard groups respectively. Of the 17 complications, 12 were surgical technique-specific. Although it appeared that there were higher rates of major, technique-specific, and overall complications in the standard access group, these differences did not reach statistical significance. Conclusions: Patients undergoing minimal access cochlear implantation require shorter operative times when compared to the standard access cochlear implantation. In addition, low complication rates are observed for major, technique-specific, and overall complications. Minimal access cochlear implantation may be considered an equivalent and potentially superior technique. (C) 2012 Elsevier Ireland Ltd. All rights reserved.