Posterior Tympanotomy Versus Subtotal Petrosectomy: A Comparison of Complications in Cochlear Implantation.

OBJECTIVE

To compare the postoperative complications between posterior tympanotomy cochlear implantation (PTCI) and subtotal petrosectomy cochlear implantation (SPCI).

STUDY

DESIGN

A retrospective cohort study.

SETTING

Two tertiary referral centers.

PATIENTS: Two hundred ninety-eight patients who underwent PTCI and 33 who underwent SPCI.

INTERVENTIONS: Cochlear implantation using either posterior tympanotomy or subtotal petrosectomy.

MAIN OUTCOME MEASURES: Postoperative complications between the two groups were compared after categorization into minor complications (requiring conservative management) and major complications (requiring surgical revision or hospitalization treatment).

RESULTS

Dizziness was the most common complication in both groups. The major complication rate in the SPCI group was significantly higher than in the PTCI group (12.1% [4 of 33] versus 1.3% [4 of 298], p = 0.004), while the minor complication rate was similar between the two groups. Among the major complications, device migration was significantly more common when SPCI was performed (9.1% [3 of 33] versus 0.3% [1 of 298], p = 0.003).

CONCLUSIONS

Major complication rate of SPCI was higher than that of PTCI; particularly, device migration was more commonly observed after SPCI than PTCI. Therefore, special attention should be paid to device placement and fixation during SPCI.