Objective: The aim of a modern cochlea implantation is an atraumatic performance. This can be objectively evaluated by the postoperative comparison of the residual hearing threshold. Since usual clinical comparisons focus on single factors like electrodes, medication, or singular steps, the surgeon and his ability as a human variable to perform the surgery in its multiple exact steps is excluded and not calculated as a variable.

The present study aimed to categorize hearing preservation surgery into different performance categories, evaluate the rate and factors, and correlate with the postoperative preserved residual hearing.

Method: We evaluated the postoperative surgical report of 87 patients with substantial residual hearing > 70 dB and categorized the surgical performance into 3 groups: A) insertion > 90 sec, constant, two-point supported, moisturized insertion, max. two trials for wide RW opening, no blood drops, no electrode flipping in the mastoid, exact coverage at the RW, etc. B) missing a single of the previously described factors, C) anatomical factors which hinder performing (1) (gusher, high facial nerve routing, etc.). Pre- and postoperative first-day hearing preservation thresholds were compared.

Results: We observed 62 Category A cases, 21 Category B cases, and 4 Category C cases. We found a highly significant correlation between surgical performance categories and the postoperative hearing threshold.

Conclusion: The surgeon's ability to perform a complex, successful hearing preservation cochlea implant surgery is critical for achieving an optimized atraumatic result.

Nein