ReviewEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
The effect of surgical complexity on hearing preservation during cochlear implantation with sheathed perimodiolar electrodes.
Review in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
purposeThe causes of residual hearing loss during cochlear implantation are generally poorly understood. This study sought to understand whether the complexity of this surgical approach related to a loss of residual hearing.
methodThirty-four adults underwent implantation with a sheathed perimodiolar electrode, via an extended round window approach. During implantation, there was simultaneous video fluoroscopy, electrocochleography (ECochG) and video from the operating microscope. Three investigators reviewed the data simultaneously. Surgery was classified as straightforward or complex, defined as difficulty with either introduction of the electrode/sheath, advancement of the electrode, or withdrawal of the sheath. ECochG signal amplitude was correlated to intracochlear electrode movements, as determined by video fluoroscopy. The primary outcome was relative hearing loss, at least six weeks after surgery. The impact of surgical complexity on relative hearing loss was assessed. A secondary outcome was the impact of surgical complexity or electrode movement on ECochG signal amplitude.
resultsComplex surgery was associated with significantly worse relative hearing preservation (p=0.011), as well as lower maximum ECochG amplitudes (Kruskal-Wallis, chi2 = 4.35, p= 0.037). After the electrode had been advanced out of the sheath, sudden fluctuations in ECochG amplitude were related to sudden changes in insertion depth. In non-complex surgeries, the residual hearing was independent of such fluctuations (Kruskal-Wallis, chi2=1.12,p=0.289).
conclusionThese data suggest residual hearing is lost early during the implant procedure, following complex surgical events. The low ECochG amplitudes encountered in complex surgeries support this interpretation. ECochG amplitude fluctuations were not associated with poorer residual hearing.
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