The effect of cochlear implant bed preparation and fixation technique on the revision cochlear implantation rate

This study aimed to determine the effect of the subperiosteal tight pocket technique versus the bone recess with suture fixation technique on the revision cochlear implantation rate and complications. This retrospective study included 1514 patients who underwent cochlear implantation by 2 senior surgeons between October 2002 and January 2016. Revision cases were identified and analysed. In all, 52 patients (3.34 per cent) underwent revision cochlear implantation. The revision rate was 7.18 per cent in the subperiosteal tight pocket group versus 2.37 per cent in the bone recess with suture fixation group (p < 0.001). Device failure was the most common reason for revision surgery in both groups. There was a significant difference in the device failure rate between the bone recess with suture fixation group (2.11 per cent) and subperiosteal tight pocket group (6.88 per cent) (p < 0.001). Accurate fixation of the cochlear implant receiver/stimulator is crucial for successful cochlear implantation. As the bone recess with suture fixation technique is associated with a lower revision rate and a similar complication rate as the subperiosteal tight pocket technique, it should be the preferred fixation technique for cochlear implantation.