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Updated: May 11, 2026
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Enhanced Cochlear Coverage and Hearing Preservation in High-Frequency Hearing Loss via Electric Acoustic Stimulation with Longer Electrode
Published on: October 11, 2024
Hearing preservation surgery: cochleostomy or round window approach? A systematic review
Sarah Havenith1, Marc J W Lammers, Rinze A Tange
1Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, The Netherlands. ent-research@umcutrecht.nl
Summary
Cochlear implant surgery for residual hearing preservation shows no clear benefit between round window or cochleostomy techniques. Further research is needed to determine the optimal approach for hearing preservation in cochlear implant patients.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- Cochlear implantation is increasingly used in patients with low-frequency residual hearing.
- Preserving residual hearing during cochlear implantation is a significant challenge.
- Optimizing surgical techniques and device properties is crucial for hearing preservation.
Purpose of the Study:
- To compare the effects of round window and cochleostomy insertion techniques on postoperative residual hearing.
- To review the evidence on surgical approaches for cochlear implantation in patients with residual hearing.
Main Methods:
- Systematic review of electronic databases up to January 2012.
- Inclusion of all studies reporting on residual hearing and hearing preservation surgery.
- Analysis of 16 studies involving 170 patients.
Main Results:
- No studies directly compared both surgical techniques.
- Methodologic quality of included studies was poor, with a high risk of bias.
- Postoperative low-frequency hearing loss ranged from 10-30 dB regardless of technique.
- Complete hearing preservation rates varied: 0-40% (cochleostomy) vs. 13-59% (round window).
Conclusions:
- Current evidence does not demonstrate a significant benefit of either the round window or cochleostomy approach for residual hearing preservation.
- A double-blind randomized trial is necessary to compare clinical outcomes and hearing preservation between the two techniques.
