Scala Tympani Cochleostomy Survey: A Follow-up Study

Objectives/Hypothesis: To reassess cochleostomy techniques among North American cochlear implant surgeons after a 6-year period of widespread education and research on the topic. Study Design: Prospective cohort study. Methods: A multiple-choice survey of cochlear implant techniques was distributed to surgeons attending the William House Cochlear Implant Study Group in 2006 and 2012. This survey contained questions regarding routine surgical access and cochleostomy techniques. Responses were anonymous, and >50% were repeat respondents. Statistical analysis sought changes in technique in the past 6 years. Results: Comparisons between 2006 and 2012 responses revealed no significant changes in the proportion of surgeons identifying the facial nerve or chorda tympani. By contrast, respondents in 2012 were more likely to drill off the round window niche overhang (P<.001), use a round window insertion (P<.001), or make a smaller cochleostomy (P-.003). In two images of a transfacial recess approach, there was a significant increase in the proportion choosing an inferior or anterior cochleostomy site over a superior location (image 1, 76% in 2006 to 92% in 2012, P=.003; image 3, 78% to 90%, respectively, P=.044). Conclusions: This repeat survey documents a change in practice among cochlear implant surgeons. Specifically, scala tympani access techniques now appear to be more consistent with known anatomical relationships in the round window region. These findings may have resulted from the concerted education and research efforts over the past 6 years.