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Round window accessibility during cochlear implantation

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

To assess data regarding round window (RW) visibility and surgical approaches in cochlear implant cases, and to describe and analyze surgical steps relevant for the RW approach in cochlear implantation.

Study design

Prospective clinical study.

Methods

A questionnaire was completed by surgeons after each of altogether 110 cochlear implantations. Round window membrane (RWM) visibility was graded according to the St Thomas Hospital (STH) classification.

Results

Performing different surgical steps during the preparation of the RW niche, the RWM could be fully exposed (STH Type I) in 87%. A RW approach could be used for electrode insertion in 89% of the adult and 78% of the pediatric cases. The distribution of RW types differed significantly between adults and children. Drilling of the superior bony lip was the surgical step most frequently needed in adult as well as pediatric cases to obtain optimal RW exposure.

Conclusion

In children, optimized surgical exposure of the RW niche resulted in only 52% full RWM visibility; whereas in adults, this could be achieved in 87%. The facial nerve (FN) had to be exposed at the level of the posterior tympanotomy in more than 70% of pediatric cases with full RWM visibility; while in adult cases with 100% visibility, such specific exposure was necessary in only 33%. Thus, surgical preparation of the RW niche seems to be more demanding in children than in adults.

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Funding

There was no financial support, no funding.

Author information

Author notes

  1. Konrad Stuermer and Tanja Winter contributed equally to this work as first authors.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, 50937, Cologne, Germany

    Konrad Stuermer, Tanja Winter, Lisa Nachtsheim, Jens Peter Klussmann & Jan Christoffer Luers

Authors
  1. Konrad Stuermer
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  2. Tanja Winter
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  3. Lisa Nachtsheim
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  4. Jens Peter Klussmann
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  5. Jan Christoffer Luers
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Contributions

All authors contributed substantially to the paper in conception, design and writing.

Corresponding author

Correspondence to Lisa Nachtsheim.

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Conflict of interest

There was no conflict of interest during the preparation of this article.

Ethical standards

The study was approved by the institutional review board (local ethics committee; No. 18-060). There were no animals involved in this study

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Informed consent was obtained from all patients

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Stuermer, K., Winter, T., Nachtsheim, L. et al. Round window accessibility during cochlear implantation. Eur Arch Otorhinolaryngol 278, 363–370 (2021). https://doi.org/10.1007/s00405-020-06095-4

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  • DOI: https://doi.org/10.1007/s00405-020-06095-4

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