The Effect of Systemic Steroid on Hearing Preservation After Cochlear Implantation via Round Window Approach

Objectives This study aims to compare the hearing preservation outcomes in cochlear implant surgery following slit versus full opening of the round window membrane. Setting Tertiary referral center. Study Design Comparative study. Subjects and Methods Seventy patients (mean, 26.3 years; range, 2-69 years) who underwent cochlear implantation via the round window approach were included in the study. Thirty-five subjects were prospectively enrolled for cochlear implantation via the open round window technique between August 2018 and January 2019. Thirty-five patients who underwent cochlear implantation from January 2017 to July 2018 via the slit round window opening, frequency matched by sex and age, were retrospectively enrolled. Pre- and postoperative thresholds were obtained. The percentage of hearing preservation was computed with the HEARRING Network formula and classified into complete, partial, and minimal hearing preservation. The results between the groups were compared and analyzed at 6 months postoperatively. Results The rate of complete hearing preservation in the open group was statistically significant ( P = .030) at 71.4% (n = 25) as compared with 45.7% (n = 16) in the slit group. Conclusions The widely opened round window may be an optional technique that surgeons can utilize to improve hearing preservation outcomes.

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Cochlear implant placement: round window approach

Neurosurgical FOCUS ◽

10.3171/2014.v1.focus13537 ◽

2014 ◽

Vol 36 (v1supplement) ◽

pp. 1 ◽

Cited By ~ 3

Author(s):

Douglas D. Backous

Keyword(s):

Clinical Trials ◽

Surgical Technique ◽

Cochlear Implant ◽

Cochlear Implantation ◽

Round Window ◽

Hearing Preservation ◽

Residual Hearing ◽

Implant Placement ◽

Single Sided Deafness ◽

Window Approach

The indications for cochlear implantation continue to extend to patients with increased levels of residual hearing. Single-sided deafness and tinnitus are currently under various clinical trials as even further expansion of the application of cochlear implant device and programming technology is underway. This video details a round window and hearing preservation approach for cochlear implant placement, and incorporates the most recent advances in surgical technique.The video can be found here: http://youtu.be/bDqkbboXrU4.

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The effect of systemic lipoic acid on hearing preservation after cochlear implantation via the round window approach: A guinea pig model

European Journal of Pharmacology ◽

10.1016/j.ejphar.2017.01.042 ◽

2017 ◽

Vol 799 ◽

pp. 67-72 ◽

Cited By ~ 5

Author(s):

Mun Young Chang ◽

Tae Mok Gwon ◽

Ho Sun Lee ◽

Jun Ho Lee ◽

Seung Ha Oh ◽

...

Keyword(s):

Guinea Pig ◽

Lipoic Acid ◽

Cochlear Implantation ◽

Round Window ◽

Hearing Preservation ◽

Pig Model ◽

Guinea Pig Model ◽

Window Approach

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Cochlear implantation and hearing preservation: Results in 21 consecutively operated patients using the round window approach

Acta Oto-Laryngologica ◽

10.3109/00016489.2012.680198 ◽

2012 ◽

Vol 132 (9) ◽

pp. 923-931 ◽

Cited By ~ 36

Author(s):

Elsa Erixon ◽

Susanne Köbler ◽

Helge Rask-Andersen

Keyword(s):

Cochlear Implantation ◽

Round Window ◽

Hearing Preservation ◽

Window Approach

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Surgical considerations during cochlear implantation: the utility of temporal bone computed tomography

The Journal of Laryngology & Otology ◽

10.1017/s0022215121000232 ◽

2021 ◽

pp. 1-8

Author(s):

Beomcho Jun ◽

Sunwha Song

Keyword(s):

Computed Tomography ◽

Temporal Bone ◽

Cochlear Implantation ◽

Round Window ◽

Three Dimensional ◽

Electrode Placement ◽

Posterior Tympanotomy ◽

Electrode Insertion ◽

Window Approach ◽

Bone Structures

Abstract Objective This paper describes the construction of portals for electrode placement during cochlear implantation and emphasises the utility of pre-operative temporal bone three-dimensional computed tomography. Methods Temporal bone three-dimensional computed tomography was used to plan portal creation for electrode insertion. Results Pre-operative temporal bone three-dimensional computed tomography can be used to determine the orientation of temporal bone structures, which is important for mastoidectomy, posterior tympanotomy and cochleostomy, and when using the round window approach. Conclusion It is essential to create appropriate portals (from the mastoid cortex to the cochlea) in a step-by-step manner, to ensure the safe insertion of electrodes into the scala tympani. Pre-operative three-dimensional temporal bone computed tomography is invaluable in this respect.

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Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach

Acta Otorhinolaryngologica Italica ◽

10.14639/0392-100x-1579 ◽

2018 ◽

Vol 38 (5) ◽

pp. 468-475

Author(s):

H. Skarzynski ◽

M. Matusiak ◽

M. Furmanek ◽

A. Pilka ◽

E. Wlodarczyk ◽

...

Keyword(s):

Round Window ◽

Hearing Preservation ◽

Window Approach ◽

Radiologic Measurement ◽

Preservation Rate

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Vestibular Preservation After Cochlear Implantation Using the Round Window Approach

Frontiers in Neurology ◽

10.3389/fneur.2021.656592 ◽

2021 ◽

Vol 12 ◽

Author(s):

Keita Tsukada ◽

Shin-ichi Usami

Keyword(s):

Cochlear Implantation ◽

Round Window ◽

Surgical Techniques ◽

Vestibular Function ◽

Vestibular Evoked Myogenic Potential ◽

Flexible Electrodes ◽

Caloric Testing ◽

Before And After ◽

Window Approach ◽

Caloric Response

Background: The development of less traumatic surgical techniques, such as the round window approach (RWA), as well as the use of flexible electrodes and post-operative steroid administration have enabled the preservation of residual hearing after cochlear implantation (CI) surgery. However, consideration must still be given to the complications that can accompany CI. One such potential complication is the impairment of vestibular function with resulting vertigo symptoms. The aim of our current study was to examine the changes in vestibular function after implantation in patients who received CI using less traumatic surgery, particularly the RWA technique.Methods: Sixty-six patients who received CI in our center were examined by caloric testing, cervical vestibular evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) before or after implantation, or both, to obtain data on semicircular canal, saccular and utricular function, respectively. Less traumatic CI surgery was performed by the use of the RWA and insertion of flexible electrodes such as MED-EL FLEX soft, FLEX 28, and FLEX 24 (Innsbruck, Austria).Results: Caloric response and the asymmetry ratio of cVEMP and oVEMP were examined before and after implantation using less traumatic surgical techniques. Compared with before implantation, 93.9, 82.4, and 92.5% of the patients showed preserved vestibular function after implantation based on caloric testing, cVEMP and oVEMP results, respectively. We also examined the results for vestibular function by a comparison of the 66 patients using the RWA and flexible electrodes, and 17 patients who underwent cochleostomy and insertion of conventional or hard electrodes. We measured responses using caloric testing, cVEMP and oVEMP in patients after CI. There were no differences in the frequencies of abnormal caloric and oVEMP results in the implanted ears between the RWA and cochleostomy. On the other hand, the frequency of abnormal cVEMP responses in the implanted ears in the patients who received implantation by cochleostomy was significantly higher than that in the patients undergoing surgery using the RWA.Conclusion: Patients receiving CI using less traumatic surgical techniques such as RWA and flexible electrodes have reduced risk of damage to vestibular function.

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