Surgical and medical complications following cochlear implantation: comparison of two surgical approaches

Our study was designed to evaluate the complication rate of cochlear implantation (CI) and to compare two different surgical approaches that are currently being used for implantations in our department. This retrospective study was conducted on the patients who underwent CI in our center between 1989 and 2003 and who were followed-up for at least 18 months. The patients were divided into two groups according to the surgical technique that had been used for the implantation: the mastoidectomy with posterior tympanotomy approach and the suprameatal approach (without mastoidectomy). The incidence of complications following CI was compared between the two groups and between children and adults. Facial nerve paralysis, electrode misplacement, injury to the chorda tympani nerve and mastoiditis occurred only in the mastoidectomy with posterior tympanotomy approach group. Acute middle ear infection with or without mastoiditis emerged as the most common complication in both groups, followed by vestibular and wound problems. Disequilibrium was significantly more common among the adults than among the children (p < 0.0001). The suprameatal approach was demonstrated as being a good alternative technique to the classical surgery for CI.