228 cases of cochlear implant receiver-stimulator placement in a tight subperiosteal pocket without fixation

Alex D. Sweeney, Matthew L. Carlson, Carla V. Valenzuela, George B. Wanna, Alejandro Rivas, Marc L. Bennett, David S. Haynes

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Objectives. (1) To investigate the outcomes of cochlear implant receiver-stimulator (RS) placement using a tight subperiosteal pocket technique without device fixation and (2) to compare the efficiency of this approach with the traditional bony well and trough technique. Study Design. Case series with planned chart review. Setting. Single tertiary academic referral center. Subjects and Methods. All cochlear implant surgeries utilizing a tight subperiosteal pocket without additional fixation or use of a bone well were identified retrospectively. Revision cases were only included if the tight subperiosteal pocket technique was used during the initial surgery. Patients with less than 6 months of postoperative follow-up were excluded. Primary outcome measures included RS migration, flap complications, device failure, and percentage reduction in operative time. Results. Two hundred twenty-eight cases (average age 45.3 years) met inclusion criterion and were analyzed. At a mean follow-up of 18.1 months, no patient experienced RS migration. One patient experienced a postoperative hematoma that was managed with observation. One patient developed a surgical site infection that resolved following exploration and intravenous antibiotics. The subperiosteal pocket technique resulted in an 18.9% reduction in total operative time compared to a more conventional RS placement method (-Rfpag>.01). Conclusions. The tight subperiosteal pocket without fixation is a safe, durable, and time-saving technique for RS placement during cochlear implantation.

Original languageEnglish
Pages (from-to)712-717
Number of pages6
JournalOtolaryngology - Head and Neck Surgery
Issue number4
StatePublished - 7 Apr 2015
Externally publishedYes


  • cochlear implant
  • sensorineural hearing loss
  • subperiosteal pocket
  • surgical technique
  • tight pocket


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