A predictive equation for operative time estimation in cochlear implant surgery

The study aimed to develop a predictive model for preoperative estimation of CI operative duration by identifying independent clinical and procedural factors that significantly influence surgical time.

Single-centre retrospective observational study.

King Abdullah Ear Specialist Center (KAESC).

A total of 216 cochlear implant patients were enrolled between 2019 and 2025.

The primary outcome was surgical time (minutes), defined as the duration from skin incision to wound closure. Secondary measures included demographic, clinical, and intraoperative factors evaluated as predictors of surgical duration. Statistical analysis was performed using SPSS version 26 and R version 4.2.2. Univariate and multivariate generalized linear models were used to identify independent predictors of surgical time and develop a final predictive model.

Surgical time was longer in females (180 vs. 150 min, p = 0.015), bilateral (190 min, p < 0.00001) and primary/revision cases (240 min, p = 0.003), and surgeries involving fellows or residents (p < 0.00001), whereas the round window approach (p = 0.036) and sealing the insertion route (p = 0.025) were associated with shorter times. In multivariate analysis, male gender was associated with a reduction in time by 16.6 min with CI 95% (-0.36, -32.77) (p = 0.0464), unilateral implantation by 62 min (p < 0.00001), and the round window technique by 28.5 min (p = 0.0445), while older age was associated with an increase in time by 0.13 min (p = 0.0034). A Consultant/Fellow/Resident team added 43 min (p = 0.0090).

The developed predictive model is a useful instrument for improving operating room management and customizing care plans in various CI practice environments.