Cochleostomy Versus Round Window Insertions: Influence on Functional Outcomes in Electric-Acoustic Stimulation of the Auditory System

Objective To assess the potential influence of 2 different surgical access routes to scala tympani for hearing preservation cochlear implantation on outcomes. Study Design Retrospective review. Setting Tertiary care academic center. Patients 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. Interventions Eight subjects (40%) were implanted using a round window-related cochleostomy and 12 subjects (60%) via a round window approach. Main Outcome Measures 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. Conclusion 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.