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<p>The cochlear implant stands unmatched in its ability to restore one of the most important human senses, hearing. When performing cochlear implantation (CI), surgeon has options to insert the electrode into the scala tympani via round window membrane approach (RWMA) or via a cochleostomy approach (CA) which can have an effect on CI speech and auditory outcomes. The aim of study is to compare outcome of CI in prelingually deaf children undergoing cochlear implantation by either RWMA versus CA. Prelingual deaf children were included in the study with 30 patients each in RWMA Group (Group A) and CA Group (Group B) after randomization. Patient accepted in candidacy meet underwent CI via a standard posterior tympanotomy approach. Depth of insertion of electrode was assessed intraoperatively both visually and based on neural response telemetry. Auditory perception and speech development was assessed by using CAP and SIR scores respectively at 0, 3, 6 and 12 months. Progressive improvement was noted post cochlear implantation in the CAP and SIR score at each follow up for all patients in both groups compared to preoperative scores, and it was found to be statistically significant. However, no statistically significant difference between the 2 groups was noted for the mean CAP score post CI. However, there was a statistically significant difference for SIR scores post cochlear implantation between the 2 groups at 6 and 12 months. Also the statistically significant better outcomes in terms of SIR score was replicated on subgroup analysis in children less than 3 years but not in those between 3–5 years at 12 months. There was no statistical difference between the 2 groups in terms of depth of insertion/incomplete insertion. Cochlear Implantation in congenital prelingual deaf children with normal inner ear anatomy and vestibulocochlear nerve anatomy show statistically significant improvement in speech development and audition with RWMA and CA. Additionally it was observed that RWMA group did statistically better in terms of speech development at 6 months and 12 months compared to CA group. However on subgroup analysis, this outcome was replicated on in children less than 3 years but not in those between 3–5 years. Furthermore, both the approaches achieved similar depth of electrode array insertion.</p>

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Comparative Analysis of Round Window and Cochleostomy Approaches in Cochlear Implantation in Prelingual Deaf Children: Auditory and Speech Outcomes

  • 期刊论文

  • 发表日期：

    2026年5月21日

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  • Sunil Goyal,
  • Kirti Sangwan,
  • Sanajeet Kumar Singh,
  • Uma Patnaik,
  • Devendra Kumar Gupta,
  • Roohie Singh

摘要

The cochlear implant stands unmatched in its ability to restore one of the most important human senses, hearing. When performing cochlear implantation (CI), surgeon has options to insert the electrode into the scala tympani via round window membrane approach (RWMA) or via a cochleostomy approach (CA) which can have an effect on CI speech and auditory outcomes. The aim of study is to compare outcome of CI in prelingually deaf children undergoing cochlear implantation by either RWMA versus CA. Prelingual deaf children were included in the study with 30 patients each in RWMA Group (Group A) and CA Group (Group B) after randomization. Patient accepted in candidacy meet underwent CI via a standard posterior tympanotomy approach. Depth of insertion of electrode was assessed intraoperatively both visually and based on neural response telemetry. Auditory perception and speech development was assessed by using CAP and SIR scores respectively at 0, 3, 6 and 12 months. Progressive improvement was noted post cochlear implantation in the CAP and SIR score at each follow up for all patients in both groups compared to preoperative scores, and it was found to be statistically significant. However, no statistically significant difference between the 2 groups was noted for the mean CAP score post CI. However, there was a statistically significant difference for SIR scores post cochlear implantation between the 2 groups at 6 and 12 months. Also the statistically significant better outcomes in terms of SIR score was replicated on subgroup analysis in children less than 3 years but not in those between 3–5 years at 12 months. There was no statistical difference between the 2 groups in terms of depth of insertion/incomplete insertion. Cochlear Implantation in congenital prelingual deaf children with normal inner ear anatomy and vestibulocochlear nerve anatomy show statistically significant improvement in speech development and audition with RWMA and CA. Additionally it was observed that RWMA group did statistically better in terms of speech development at 6 months and 12 months compared to CA group. However on subgroup analysis, this outcome was replicated on in children less than 3 years but not in those between 3–5 years. Furthermore, both the approaches achieved similar depth of electrode array insertion.