Abstract
Introduction Posterior tympanotomy approach for cochlear implant (CI) surgery, has been the most
commonly used worldwide with current 0.7% rate of facial nerve injury. Non-mastoidectomy
CI approaches include the suprameatal approach (SMA) and its modifications, the transcanal
approach and its modifications and the pericanal approach for electrode insertion.
Objectives The objective of this study was to review the literature regarding non-mastoidectomy
CI approaches.
Data Synthesis A search was performed in the LILACS, MEDLINE, SciELO, PubMed databases and Cochrane
Library in February 2015, and the key words used in the search were CI, SMA, transcanal
approach, pericanal approach, or electrode extrusion. About 30 studies that met the
criteria described in “Study Selection” were read in full. The studies showed 1014
patients that underwent CI by SMA or its modifications, 266 CI patients treated by
transcanal approach or its modifications, and 15 patients implanted by the pericanal
approach. Reported complication with SMA was 99 (9.8%) minor and 13 (1.3%) major.
With transcanal, there were 24 complications; 19 (7.1%) minor and 5 (1.9%) major.
No post-operative complication was reported in pericanal approach. Studies showed
no reported facial nerve paresis or paralysis in all non-mastoidectomy approaches.
Conclusion Complications rates with non-mastoidectomy approaches are similar to those found
in the mastoidectomy approach. Thus, non-mastoidectomy approaches may be an alternative
in cases where the conventional mastoidectomy approach is difficult to perform. It
would be helpful for CI surgeons to become familiarized with these approaches.
Keywords
cochlear implant - mastoidectomy - facial nerve
