Comparison of Cochlear Implant Device Fixation-Well Drilling Versus Subperiosteal Pocket. A Cost Effectiveness, Case-Control Study.

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To compare surgical characteristics and complications between well drilling (WD) and subperiosteal pocket techniques (SPT) for receiver/stimulator (R/S) fixation of cochlear implant (CI), and conduct cost-effectiveness analysis.Retrospective clinical study, decision-analysis model.Tertiary referral center.Three-hundred and eighty-eight CI recipients with a minimum of 6-months follow-up.CI surgery using either WD or SPT for R/S fixation. A decision-analysis model was designed using data from a systematic literature review.Surgical operation time, rates of major and minor long-term complications were compared. Incremental cost-effectiveness was also estimated, comparing the two methods of fixation.We compared 179 WD with 209 SPT. Surgery time was significantly shorter in SPT (148 versus 169 min, p = 0.001) and remained significant after adjustment for possible confounders. Higher rates of major complications requiring surgical intervention were found with SPT (10.5% versus 4.5%, p = 0.042), however, the difference was not significant after adjusting for follow-up time (47.8 versus 32.5 months for SPT, WD respectively; p 

View the full article @ Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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Authors: Sagit Stern Shavit, Emery P Weinstein, Madeleine A Drusin, Elena B Elkin, Lawrence R Lustig, George Alexiades