Sentinel node biopsy performance after neoadjuvant chemotherapy in locally advanced breast cancer: a systematic review and meta-analysis Simone

  • Simone M
  • Noble J
  • Carlson M
 et al. 
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Hypothesis: Three surgical approaches, cochleostomy (C), round window (RW), and extended round window (ERW) and two electrodes types, lateral wall (LW) and perimodiolar (PM), account for the vast majority of cochlear implantations. The goal of this study was to analyze the relationship between surgical approach and electrode type with final intracochlear position of the electrode array and subsequent hearing outcomes. Study Design: Comparative longitudinal study. Methods: One hundred postlingually implanted adult patients were enrolled in the study. From the post-operative scan, intracochlear electrode location was determined by using rigid registration, transformed back to the pre-operative CT. Likelihood ratio chi-square statistics were used to evaluate for differences in electrode placement with respect to surgical approach (C, RW, ERW) and type of electrode (LW, PM). Results: Electrode placement completely within the ST was more common for LW than PM designs (89% vs 58%, p < 0.001). RW and ERW approaches were associated with lower rates of electrode placement outside the ST than for the cochleostomy approach (9%, 16% and 63%, respectively, p < 0.001). This pattern held true regardless of whether the implant was LW or PM. When examining electrode placement and hearing outcome, those with electrode residing completely within the ST had better CNC word scores than patients with any number of electrodes located outside the ST (p=0.045). Conclusion: These data suggest that RW and ERW approaches and LW electrodes are associated with an increased likelihood of successful ST placement. Furthermore, electrode position entirely within the ST confers superior audiological outcomes

Author-supplied keywords

  • auditory rehabilitation
  • cochlear implant
  • cochleostomy
  • electrode
  • round window
  • sensorineural hearing loss

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  • Mocellin Simone

  • Jack H Noble

  • Matthew L Carlson

  • H Gifford

  • Mary S Dietrich

  • David S Haynes

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