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Acta Otorrinolaringol Esp. 2012 Sep-Oct;63(5):327-31. doi: 10.1016/j.otorri.2012.01.012. Epub 2012 Mar 16.

Comparison of complications by technique used in cochlear implants.

[Article in English, Spanish]

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Sanatorio Allende, Córdoba, Argentina.



Complications are a very sensitive indicator of the usefulness of a surgical technique. In cochlear implant surgery, there are 3 principal approaches: the classic approach uses the facial recess (FR), the suprameatal approach (SMA) does not require mastoidectomy and uses the creation of a tunnel over the facial nerve to enter the middle ear, and the endomeatal approach (EMA) is based on the completion of a groove in the posterior wall of external auditory canal.


A multicentre review of 208 patients with cochlear implants, comparing the different techniques. The complications were classified into major and minor.


Among the 208 implanted patients, 10.5% (22 of 208) had complications. Of these, 2.88% (6 of 208) were major complications and 7.69% (16 of 208) were minor complications. Comparing the results obtained by the different approaches, the FR technique had the lowest rate of major complications (1.1%), followed by the EMA technique with 2.38% and SMA with 3.75%. As for minor complications, operations in the SMA group had the lowest rate (6.25%), followed by the EMA group (7.14%) and the group operated on using the FR technique presented the highest (10%).


The 3 techniques described show very similar rates of complications. Consequently, we can conclude that they are safe and are alternatives.

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