Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Otol Neurotol. 2012 Dec;33(9):1497-501. doi: 10.1097/MAO.0b013e31826a52c7.
To demonstrate that the round window insertion (RWI) for cochlear implantation with multichannel electrodes is a reliable, safe, and effective technique.
Retrospective case review.
Academic tertiary referral center.
One hundred thirty consecutive cochlear implants (72 female and 58 male subjects) performed from August 2009 to August 2011. Devices included 83 Cochlear, 40 Med El, and 7 Advanced Bionics (AB) cochlear implants.
Subsequent to a full audiometric assessment, patients underwent a mastoidectomy with facial recess approach whereby the primary surgical objective was to perform a RWI. When the surgeon was unable to access the round window safely, a cochleostomy was performed anterior and inferior to the round window. Postoperative performance was measured with Hearing in Noise Test, the Consonant-Nucleus-Consonant test, and/or the Arizona Biomedical Sentences test.
Surgical feasibility of reliably performing a RWI, reason for cochleostomy, postoperative complications, and audiometric performance.
In 111 (85.4%) of 130 procedures, a RWI was performed; in 19 (14.6%), a cochleostomy was readily performed by the same approach. Reasons for creating a cochleostomy included facial nerve and jugular bulb location. There were no major postoperative complications in either group and 13 total minor complications. There was no statistically significant difference in postoperative complications or in audiometric performance between the 2 groups.
The RWI may offer several advantages over a cochleostomy, and it seems to be a reliable, safe, and effective technique for cochlear implantation with today's cochlear implant electrodes. Further studies would be necessary to verify these findings for broad application to the cochlear implant patient population.
证明圆窗植入（RWI）用于多通道电极的耳蜗植入是一种可靠、安全且有效的技术。
回顾性病例研究。
学术三级转诊中心。
2009 年 8 月至 2011 年 8 月连续进行的 130 例耳蜗植入（72 例女性和 58 例男性）。设备包括 83 个 Cochlear、40 个 Med El 和 7 个 Advanced Bionics（AB）耳蜗植入。
在进行全面听力评估后，患者接受乳突切除术和面神经隐窝入路，主要手术目标是进行 RWI。当外科医生无法安全地进入圆窗时，在前部和圆窗下方进行耳蜗造口术。术后表现通过噪声下听力测试、辅音-核-辅音测试和/或亚利桑那生物医学句子测试进行测量。
可靠进行 RWI 的手术可行性、耳蜗造口术的原因、术后并发症和听力表现。
在 130 例手术中的 111 例（85.4%）中进行了 RWI；在 19 例（14.6%）中，通过相同的方法容易地进行了耳蜗造口术。进行耳蜗造口术的原因包括面神经和颈静脉球的位置。两组均无重大术后并发症，总共有 13 例轻微并发症。两组之间在术后并发症或听力表现方面无统计学显著差异。
与耳蜗造口术相比，RWI 可能具有多个优势，并且对于使用当今的耳蜗植入电极进行耳蜗植入似乎是一种可靠、安全且有效的技术。需要进一步的研究来验证这些发现，以便广泛应用于耳蜗植入患者群体。
