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Comparison of the Pediatric Cochlear Implantation Using Round Window and Cochleostomy
Masoud Naderpour1, Zohreh Aminzadeh1, Yalda Jabbari Moghaddam1
1Department of Otorhinolaryngology, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Cochlear implantation (CI) using either the round window approach (RWA) or standard cochleostomy approach (SCA) improves hearing and speech in children. While RWA showed better mid-term speech intelligibility, long-term outcomes were similar for both methods.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Cochlear implantation (CI) is a standard treatment for pediatric sensorineural hearing loss.
- Comparing surgical approaches is crucial for optimizing outcomes.
Purpose of the Study:
- To compare the efficacy of the round window approach (RWA) and standard cochleostomy approach (SCA) for residual hearing preservation in pediatric CI patients.
Main Methods:
- A double-blind randomized controlled trial involving 97 pediatric patients with 12-month follow-up.
- Patients were divided into RWA and SCA groups.
- Evaluated using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scales at multiple time points.
Main Results:
- Both RWA and SCA significantly improved CAP and SIR scores over 12 months.
- No significant difference in CAP scores between groups.
- RWA showed significantly higher SIR scores at 3, 6, and 9 months, but no significant difference at 12 months.
Conclusions:
- Both RWA and SCA effectively improve hearing and speech in pediatric CI patients.
- RWA offers superior mid-term speech intelligibility, but long-term results are comparable to SCA.
Introduction:
Cochlear implantation (CI) is now regarded as a standard treatment for children with severe to profound sensor neural hearing loss. This study aimed to compare the efficacy of the round window approach (RWA) and standard cochleostomy approach (SCA) in the preservation of residual hearing after CI in pediatric patients.
Materials And Methods:
This double-blind randomized controlled trial was conducted on 97 pediatric patients receiving CI with 12-month follow-up. The study population was divided into two groups according to the surgical approaches they received, including RWA and SCA. Consequently, the patients were evaluated based on the Categories of Auditory Performance scale (CAP) and Speech Intelligibility Rating (SIR) test 45-60 days and 3, 6, 9, and 12 months post-surgery.
Results:
The CAP and SIR mean scores increased in both groups during the 12-month follow-up. This upward trend was significant in both groups (P<0.001). There was no significant difference between the two treatment groups in any of the follow-up stages regarding the CAP mean score. The mean SIR score (P=1.14±0.40) was significantly higher in the RWA group 3(P=0.001), 6(P=0.008), and 9(P=0.006) months after the surgery. However, there was no significant difference between the RWA and SCA groups, regarding 1-year SIR (P=0.258).
Conclusion:
The CI with either RWA or SCA could improve hearing and speech performance in pediatric patients. Although mid-term speech intelligibility was better for RWA, there was no significant difference in the 1-year outcome between these two methods.
