The Role of Mastoidectomy in Cochlear Implant Surgery

OBJECTIVE: The classical technique for cochlear implantation (CI) involves mastoidectomy and posterior tympanotomy. The question raised in this work is whether mastoidectomy is indispensable in CI surgery. MATERIAL AND METHODS: The advantages and disadvantages of performing mastoidectomy during CI surgery were weighed, in particular the effect of mastoidectomy on chronic secretory otitis media (SOM) and the ability of the electrode to expand in the mastoid during skull growth. RESULTS: No effect of mastoidectomy on chronic SOM was found and the assumption that the electrode in the mastoid cavity has the ability to expand during skull growth was not proven. Eliminating mastoidectomy in CI surgery simplifies the procedure, shortens the duration of surgery, minimizes the amount of drilling and provides broader, better exposure of the middle ear and promontory. Mastoidectomy was found not to be obligatory in CI surgery and in fact may have more disadvantages than advantages. CONCLUSION: The development of alternative CT techniques which eliminate the need for mastoidectomy is justified.