Minimally Traumatic Cochlear Implant Surgery: Expert Opinion in 2010 and 2020

Area of Science:

• Otolaryngology
• Neurosurgery
• Biomedical Engineering

Background:

• Cochlear implantation (CI) is a vital treatment for severe to profound hearing loss.
• Preserving residual hearing during CI surgery is a key goal for optimal patient outcomes.
• Surgical techniques for CI have advanced, necessitating updated expert consensus.

Purpose of the Study:

• To survey current expert opinions on cochlear implant (CI) surgical techniques for hearing preservation.
• To compare contemporary expert views with those from 2010.
• To identify areas of consensus and disagreement in CI soft surgery.

Main Methods:

• Adaptation and expansion of a previously published 2010 questionnaire.
• Distribution to an international cohort of experienced CI surgeons.
• Descriptive statistical analysis comparing current results with 2010 data.

Main Results:

• Strong preference for round window insertion, slow array insertion, and systematic antibiotic use.
• Importance of insertion depth and selection of trauma-minimizing electrode arrays.
• Recognition of dedicated soft-surgery training; disagreement on middle ear flushing and array protection methods.

Conclusions:

• Expert opinions on CI soft surgery techniques have shifted since 2010.
• Consensus exists on several key techniques for hearing preservation.
• Areas requiring further research and standardization include middle ear irrigation and array contamination prevention.