Chantal Snels1, Joanna IntHout2, Emmanuel Mylanus1,3, Wendy Huinck3, Ingeborg Dhooge1. 1. Department of Otorhinolaryngology, Ghent University, Ghent, Belgium. 2. Department for Health Evidence, Radboud Institute for Health Sciences. 3. Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
OBJECTIVE(S): The aim of the present meta-analysis is to assess the effects of hearing preservation (HP) methods on residual hearing in patients undergoing cochlear implant (CI) surgery and to look at the effect of follow-up time on HP outcome. DATA SOURCES: A systematic search was conducted in PubMed, Embase, and Cochrane Library. Only articles in English were included. STUDY SELECTION: Prospective studies published until January 2018 on hearing preservation methods were included. DATA EXTRACTION: Studies were assessed on unaided pre- and postoperative hearing thresholds, follow up time, and methodological quality. DATA SYNTHESIS: A random-effects meta-regression was performed for the HP outcome in relation to surgical technique, electrode array design, inserted electrode length, insertion speed, and corticosteroid use for different follow up times (1 month, 6 months, and 12 months or more postoperatively). CONCLUSION: Hearing preservation in cochlear implant surgery is feasible. A statistically significant difference was found between the round window procedure and cochleostomy approach, in favor of the round window procedure at 6 months postoperatively (p = 0.001). A statistically significant difference was found between the straight and the perimodiolar electrode array at 1 month postoperatively in favor of the straight electrode array (p < 0.001). No statistically significant difference was found between the other HP methods. The round window approach with the straight electrode array might result in a better HP outcome at 1 month and 6 months postoperatively compared with the cochleostomy approach with the perimodiolar electrode array. A declining trend in HP outcome in both combinations was seen over time.
OBJECTIVE(S): The aim of the present meta-analysis is to assess the effects of hearing preservation (HP) methods on residual hearing in patients undergoing cochlear implant (CI) surgery and to look at the effect of follow-up time on HP outcome. DATA SOURCES: A systematic search was conducted in PubMed, Embase, and Cochrane Library. Only articles in English were included. STUDY SELECTION: Prospective studies published until January 2018 on hearing preservation methods were included. DATA EXTRACTION: Studies were assessed on unaided pre- and postoperative hearing thresholds, follow up time, and methodological quality. DATA SYNTHESIS: A random-effects meta-regression was performed for the HP outcome in relation to surgical technique, electrode array design, inserted electrode length, insertion speed, and corticosteroid use for different follow up times (1 month, 6 months, and 12 months or more postoperatively). CONCLUSION: Hearing preservation in cochlear implant surgery is feasible. A statistically significant difference was found between the round window procedure and cochleostomy approach, in favor of the round window procedure at 6 months postoperatively (p = 0.001). A statistically significant difference was found between the straight and the perimodiolar electrode array at 1 month postoperatively in favor of the straight electrode array (p < 0.001). No statistically significant difference was found between the other HP methods. The round window approach with the straight electrode array might result in a better HP outcome at 1 month and 6 months postoperatively compared with the cochleostomy approach with the perimodiolar electrode array. A declining trend in HP outcome in both combinations was seen over time.
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