Posterior Tympanotomy Versus Subtotal Petrosectomy: A Comparison of Complications in Cochlear Implantation

Otol Neurotol. 2021 Feb 1;42(2):260-265. doi: 10.1097/MAO.0000000000002899.

Abstract

Objective: To compare the postoperative complications between posterior tympanotomy cochlear implantation (PTCI) and subtotal petrosectomy cochlear implantation (SPCI).

Study design: A retrospective cohort study.

Setting: Two tertiary referral centers.

Patients: Two hundred ninety-eight patients who underwent PTCI and 33 who underwent SPCI.

Interventions: Cochlear implantation using either posterior tympanotomy or subtotal petrosectomy.

Main outcome measures: Postoperative complications between the two groups were compared after categorization into minor complications (requiring conservative management) and major complications (requiring surgical revision or hospitalization treatment).

Results: Dizziness was the most common complication in both groups. The major complication rate in the SPCI group was significantly higher than in the PTCI group (12.1% [4 of 33] versus 1.3% [4 of 298], p = 0.004), while the minor complication rate was similar between the two groups. Among the major complications, device migration was significantly more common when SPCI was performed (9.1% [3 of 33] versus 0.3% [1 of 298], p = 0.003).

Conclusions: Major complication rate of SPCI was higher than that of PTCI; particularly, device migration was more commonly observed after SPCI than PTCI. Therefore, special attention should be paid to device placement and fixation during SPCI.

MeSH terms

  • Cochlear Implantation* / adverse effects
  • Cochlear Implants*
  • Craniotomy
  • Humans
  • Middle Ear Ventilation / adverse effects
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Reoperation
  • Retrospective Studies