Stepwise Standardization of the Subperiosteal Pocket Technique in Cochlear Implantation: Effects on Surgical Efficiency and Consistency

Stepwise analysis of the SPT in CI

Abstract

Objective: The subperiosteal pocket technique (SPT) is widely used in cochlear implantation (CI) for its ability to reduce operative time and minimize complications. This study revisits the technique, focusing on surgical efficiency, stepwise analysis, and implications for training.

Methods: A retrospective analysis of 160 pediatric CI cases was conducted. The total surgery time and durations of eight defined steps were documented, and practical insights were integrated to optimize outcomes.

Results: The cumulative surgical step durations averaged 37.2 ± 6.2 minutes. The most time-intensive steps included suturing and skin closure (13.4 ± 3 minutes) and posterior tympanotomy (7.1 ± 2.7 minutes). These steps were critically analyzed for efficiency and educational value.

Conclusion: The SPT is comparable to conventional methods in safety and effectiveness , with the added benefits of reduced operative time and enhanced training potential. This study provides detailed guidance to improve surgical workflow and education in CI.