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Does cochleostomy location influence electrode trajectory and intracochlear trauma?

Introduction With expanding indications for cochlear implantation including implantation of patients with residual acoustic hearing, atraumatic implantation is of the utmost importance. Some factors related to surgical technique including cochleostomy (CO) location may impact on intracochlear trauma, and subsequently on rates of hearing preservation (Holden et al., 2013; O’Leary et al., 2013). Furthermore, trauma to the cochlea results in fibrosis and neo-ossification which may preclude future therapies for sensorineural hearing loss. For these reasons, continued advancement of surgical technique and electrode design are critical in providing future cochlear implant users with the best possible outcomes. This study sought to examine three different surgical approaches: the CO, peri-round window (PRW), and round window (RW) in a temporal bone model, by histology and fluoroscopy.