Cochlear Implant Performance after Round Window Insertion

Abstract

Objective: To compare speech performance after undergoing round window (RW) electrode insertion with those who underwent traditional cochleostomy (C) cochlear implant (CI) surgery. Method: Study design: Prospective study. Setting: Academic cochlear implant center. Patients who met CI criteria with favorable intraoperative RW anatomy who underwent RW CI electrode insertion were included. Patients meeting CI criteria who underwent traditional cochleostomy surgery were matched for age, duration of deafness, and preoperative hearing to serve as the comparison group. Intervention: RW versus traditional C electrode insertion. Main outcome measures: Postoperative speech performance using the consonant-nucleus-consonant (CNC) speech perception tested between 3 to 24 months after CI implantation. Results: Eighty-seven patients underwent RW insertion between 2007 to 2011. Thirty-two patients had pre- and postoperative speech perception data for analysis. Age ranged from 9.7 to 79.4 years (mean, 53.9 ± 16.1 years). A total of 18 patients who underwent C insertion were identified, ranging in age from 37.8 to 68.3 years (mean, 51.4 ± 16.1 years). No significant differences in postoperative CI speech perception scores were noted between the RW and C group at 1 year post-CI (RW group 53.6 ± 23.2% versus C group 56.2 ± 21.4%; P = .73). Conclusion: Our study suggests that in patients with favorable RW anatomy, RW cochlear implant electrode insertion demonstrated comparable speech performance compared to the traditional cochleostomy insertion.