Minimal access and standard cochlear implantation: a comparative study

To compare the operative times and complications between patients who underwent minimal access cochlear implantation and standard technique cochlear implantation.

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 (~8-10 cm) with bone well creation and suture fixation. Outcomes include operative times and complications.

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.

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.