Frontiers in surgery · 2026
Towards a consensus on hearing and structure preservation in cochlear implantation surgery: results of the HEARRING international group survey.
СтатьяНазвание и аннотация: Перевод в очереди
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Van de Heyning Paul, Usami Shin-Ichi, Topsakal Vedat, Skarzynski Piotr H, Acharya Aanand, Bajin Munir Demir, Calvino Miryam, Caversaccio Marco, Dazert Stefan, Gavilán Javier, Ghiselli Sara, Hofkens Anouk, Kameswaran Mohan, Kurz Anja, Lammers Marc, Lorens Artur, Mertens Griet, Overton Andrea B, Prepageran Narayanan, Pulibalathingal Sasidharan, Raine Christopher H, Rajeswaran Ranjith, Rak Kristen, Schmutzhard Joachim, Thompson Nicholas, Van Rompaey Vincent, Völter Christiane, Yousef Medhat, Zernotti Mario E, Hagen Rudolf
Аннотация
BACKGROUND: To evaluate current clinical practices, attitudes, and considerations regarding hearing and structure preservation (HSP) in cochlear implant surgery among international experts.
METHODS: A cross-sectional online survey comprising 42 structured items was distributed to 75 HEARRING members, including surgeons, audiologists, and scientists. The questionnaire covered HSP indications and candidate evaluation, electrode array selection, surgical techniques, fitting strategies, and training.
RESULTS: Thirty-one experts from 16 countries completed the survey. Most respondents (87.1%) supported HSP surgery in all patients with normal cochlear anatomy, regardless of the severity of hearing loss, primarily to preserve cochlear structures and optimize long-term outcomes. Strong consensus emerged regarding atraumatic principles, including slow electrode array insertion, flexible electrode arrays, round window access, and routine intraoperative corticosteroid use. Image-based planning was unanimously endorsed for electrode array selection, and all experts favoured longer electrode arrays even in patients with functional low-frequency hearing. Variability persisted in the adoption of genetic testing, perioperative management, intraoperative monitoring, and fitting strategies, although anatomy-based fitting was most frequently selected. Training of surgeons and audiologists was universally regarded as essential.
CONCLUSIONS: This survey demonstrates a clear evolution toward a shared expert framework for HSP-oriented cochlear implantation surgery, with several principles approaching consensus. Remaining variability highlights a) areas for future research and development and b) supports the continued international collaboration toward standardized HSP practice.
METHODS: A cross-sectional online survey comprising 42 structured items was distributed to 75 HEARRING members, including surgeons, audiologists, and scientists. The questionnaire covered HSP indications and candidate evaluation, electrode array selection, surgical techniques, fitting strategies, and training.
RESULTS: Thirty-one experts from 16 countries completed the survey. Most respondents (87.1%) supported HSP surgery in all patients with normal cochlear anatomy, regardless of the severity of hearing loss, primarily to preserve cochlear structures and optimize long-term outcomes. Strong consensus emerged regarding atraumatic principles, including slow electrode array insertion, flexible electrode arrays, round window access, and routine intraoperative corticosteroid use. Image-based planning was unanimously endorsed for electrode array selection, and all experts favoured longer electrode arrays even in patients with functional low-frequency hearing. Variability persisted in the adoption of genetic testing, perioperative management, intraoperative monitoring, and fitting strategies, although anatomy-based fitting was most frequently selected. Training of surgeons and audiologists was universally regarded as essential.
CONCLUSIONS: This survey demonstrates a clear evolution toward a shared expert framework for HSP-oriented cochlear implantation surgery, with several principles approaching consensus. Remaining variability highlights a) areas for future research and development and b) supports the continued international collaboration toward standardized HSP practice.