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.