{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:20:35Z","timestamp":1792790435840,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012352","name":"Universit\u00e0 degli Studi di Milano","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To discuss indications (unfavorable conditions), surgical steps, complications, and follow-up of subtotal petrosectomy (STP) in cochlear implantation based on our experience of 348 cases. Anatomical variations associated with or without cochlear malformations and differences between electrode insertions were included in our analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>A retrospective case study was done in Gruppo Otologico (Piacenza, Italy), a quaternary referral center. Among 1002 cases that underwent subtotal petrosectomy, 348 were selected for cochlear implantation in the same setting. The study period was from 2004 to 2019. These patients\u2019 clinical and radiological follow-up ranged from 2 months to 180 months. Data were inspected, cleaned, and analyzed by SPSS software.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The selected group\u2019s mean age was 57.236 years, including 178 male and 170 female patients. The follow-up period lasted up to 108.65 months. Out of 348 cases, 8 were children (under the age of 18 years old). Inclusion criteria to be eligible for cochlear implantation in the same setting of subtotal petrosectomy was a preoperative pure tone average (PTA) of more than 90 decibels associated with low speech discrimination ranging from 0% in most cases up to 50% in the minority. 329 patients had a complete electrode insertion intra-operatively. Minor complications were observed in 6 cases. These include one case of implant extrusion due to a middle ear infection leading to labyrinthitis, three cases of post-auricular fistula causing one device failure, one subcutaneous CSF collection, and one subcutaneous seroma collection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Although in most cases, standardized trans mastoid facial recess technique for cochlear implantation is ideal as the surgical risks are minimal, in complicated cases such as concomitant chronic otitis media, prior canal wall-down cases, radical cavities, or inner ear abnormalities with high risk of cerebrospinal fluid leak subtotal petrosectomy should be the first choice of management with complete disease clearance. Close clinical and radiological follow-up is therefore mandatory. Single-stage implantation is preferred to staging the procedure unless one is unsure of disease clearance.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00405-025-09431-8","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T15:32:54Z","timestamp":1747323174000},"page":"5091-5099","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Subtotal petrosectomy in cochlear implantation: Gruppo Otologico experience after 348 cases"],"prefix":"10.1007","volume":"282","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5042-3103","authenticated-orcid":false,"given":"Luca","family":"Morelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin K.","family":"Damam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailu","family":"Yilala M.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Fancello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ferraro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Caruso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"9431_CR1","doi-asserted-by":"publisher","unstructured":"Free RH, Falcioni M, Di Trapani G, Giannuzzi AL, Russo A, Sanna M (2013) The role of subtotal petrosectomy in cochlear implant surgery\u2013a report of 32 cases and review on indications. Otol Neurotol 34(6):1033-40. https:\/\/doi.org\/10.1097\/MAO.0b013e318289841b. PMID: 23856625","DOI":"10.1097\/MAO.0b013e318289841b"},{"key":"9431_CR2","doi-asserted-by":"publisher","unstructured":"RAMBO JH (1958) Primary closure of the radical mastoidectomy wound: a technique to eliminate postoperative care. Laryngoscope 68(7):1216-27. https:\/\/doi.org\/10.1002\/lary.5540680707. PMID: 13576888","DOI":"10.1002\/lary.5540680707"},{"key":"9431_CR3","doi-asserted-by":"publisher","unstructured":"Bartels LJ, Sheehy JL (1981) Total obliteration of the mastoid, middle ear, and external auditory canal. A review of 27 cases. Laryngoscope 91(7):1100-8. https:\/\/doi.org\/10.1288\/00005537-198107000-00007. PMID: 7242201","DOI":"10.1288\/00005537-198107000-00007"},{"key":"9431_CR4","volume-title":"Microsurgery of the skull base","year":"1988","unstructured":"Fisch U, Mattox (eds) (1988) Microsurgery of the skull base. Georg Thieme, Stuttgart, Germany"},{"key":"9431_CR5","doi-asserted-by":"publisher","unstructured":"Bernardeschi D, Nguyen Y, Smail M, Bouccara D, Meyer B, Ferrary E, Sterkers O, Mosnier I (2015) Middle ear and mastoid obliteration for cochlear implant in adults: indications and anatomical results. Otol Neurotol 36(4):604-9. https:\/\/doi.org\/10.1097\/MAO.0000000000000702. PMID: 25569370","DOI":"10.1097\/MAO.0000000000000702"},{"key":"9431_CR6","doi-asserted-by":"publisher","unstructured":"Pasanisi E, Vincenti V, Bacciu A, Guida M, Berghenti T, Barbot A, Zini C, Bacciu S (2002) Multichannel cochlear implantation in radical mastoidectomy cavities. Otolaryngol Head Neck Surg 127(5):432-6. https:\/\/doi.org\/10.1067\/mhn.2002.129822. PMID: 12447237","DOI":"10.1067\/mhn.2002.129822"},{"issue":"1","key":"9431_CR7","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/MAO.0b013e31815dbb40","volume":"29","author":"M Sanna","year":"2008","unstructured":"Sanna M, Dispenza F, Flanagan S, De Stefano A, Falcioni M (2008) Management of chronic otitis by middle ear obliteration with blind sac closure of the external auditory Canal. Otol Neurotol 29(1):19\u201322. https:\/\/doi.org\/10.1097\/MAO.0b013e31815dbb40PMID: 18199953","journal-title":"Otol Neurotol"},{"key":"9431_CR8","doi-asserted-by":"crossref","unstructured":"Coker NJ, Jenkins HA, Fisch U (1986) Obliteration of the middle ear and mastoid cleft in subtotal petrosectomy: indications, technique, and results. Ann Otol Rhinol Laryngol. Jan-Feb 95(1 Pt 1):5\u201311. doi: 10.1177\/000348948609500102. PMID: 3947004","DOI":"10.1177\/000348948609500102"},{"key":"9431_CR9","doi-asserted-by":"publisher","unstructured":"Issing PR, Sch\u00f6nermark MP, Winkelmann S, Kempf HG, Ernst A (1998) Cochlear implantation in patients with chronic otitis: indications for subtotal petrosectomy and obliteration of the middle ear. Skull Base Surg 8(3):127\u201331. https:\/\/doi.org\/10.1055\/s-2008-1058571. PMID: 17171047","DOI":"10.1055\/s-2008-1058571"},{"key":"9431_CR10","doi-asserted-by":"publisher","unstructured":"Bendet E, Cerenko D, Linder TE, Fisch U (1998) Cochlear implantation after subtotal petrosectomies. Eur Arch Otorhinolaryngol 255(4):169\u201374. https:\/\/doi.org\/10.1007\/s004050050037. PMID: 9592672","DOI":"10.1007\/s004050050037"},{"issue":"4","key":"9431_CR11","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1177\/0194599816651239","volume":"155","author":"JB Hunter","year":"2016","unstructured":"Hunter JB, O\u2019Connell BP, Wanna GB (2016) Systematic review and Meta-analysis of surgical complications following cochlear implantation in Canal wall down mastoid cavities. Otolaryngol Head Neck Surg 155(4):555\u2013563 Epub 2016 May 24. PMID: 27221577","journal-title":"Otolaryngol Head Neck Surg"},{"key":"9431_CR12","doi-asserted-by":"publisher","unstructured":"Linthicum FH Jr (2002) The fate of mastoid obliteration tissue: a histopathological study. Laryngoscope 112(10):1777-81. https:\/\/doi.org\/10.1097\/00005537-200210000-00013. PMID: 12368614","DOI":"10.1097\/00005537-200210000-00013"},{"key":"9431_CR13","doi-asserted-by":"publisher","unstructured":"Casserly P, Friedland PL, Atlas MD (2016) The role of subtotal petrosectomy in cochlear implantation. J Laryngol Otol 130 Suppl 4:S35-40. https:\/\/doi.org\/10.1017\/S0022215116000979. PMID: 27488335","DOI":"10.1017\/S0022215116000979"},{"issue":"11","key":"9431_CR14","doi-asserted-by":"publisher","first-page":"3641","DOI":"10.1007\/s00405-016-4005-6","volume":"273","author":"S Lyutenski","year":"2016","unstructured":"Lyutenski S, Schwab B, Lenarz T, Salcher R, Majdani O (2016) Impact of the surgical wound closure technique on the revision surgery rate after subtotal petrosectomy. Eur Arch Otorhinolaryngol 273(11):3641\u20133646. https:\/\/doi.org\/10.1007\/s00405-016-4005-6Epub 2016 Mar 25. PMID: 27015665","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"9431_CR15","doi-asserted-by":"publisher","unstructured":"Leung R, Briggs RJ (2007) Indications for and outcomes of mastoid obliteration in cochlear implantation. Otol Neurotol 28(3):330-4. https:\/\/doi.org\/10.1097\/01.mao.0000265187.45216.71. PMID: 17414038","DOI":"10.1097\/01.mao.0000265187.45216.71"},{"key":"9431_CR16","doi-asserted-by":"publisher","unstructured":"Bara\u00f1ano CF, Kopelovich JC, Dunn CC, Gantz BJ, Hansen MR (2013) Subtotal petrosectomy and mastoid obliteration in adult and pediatric cochlear implant recipients. Otol Neurotol 34(9):1656-9. https:\/\/doi.org\/10.1097\/MAO.0b013e3182a006b6. PMID: 24136310","DOI":"10.1097\/MAO.0b013e3182a006b6"},{"issue":"2","key":"9431_CR17","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s00405-015-3573-1","volume":"273","author":"M Szyma\u0144ski","year":"2016","unstructured":"Szyma\u0144ski M, Ataide A, Linder T (2016) The use of subtotal petrosectomy in cochlear implant candidates with chronic otitis media. Eur Arch Otorhinolaryngol 273(2):363\u2013370. https:\/\/doi.org\/10.1007\/s00405-015-3573-1Epub 2015 Feb 24. PMID: 25708413","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"9431_CR18","unstructured":"Sanna M et.al Surgery for Cochlear and Other auditory implants by Thieme - ISBN 978-3-13-176441-6"},{"issue":"6","key":"9431_CR19","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1177\/0003489415620427","volume":"125","author":"R Polo","year":"2016","unstructured":"Polo R, Del Mar Medina M, Ar\u00edstegui M, Lassaletta L, Gutierrez A, Ar\u00e1nguez G, Prasad SC, Alonso A, Gavil\u00e1n J, Sanna M (2016) Subtotal petrosectomy for cochlear implantation: lessons learned after 110 cases. Ann Otol Rhinol Laryngol 125(6):485\u2013494 Epub 2015 Dec 9. PMID: 26658067","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"6","key":"9431_CR20","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1159\/000507419","volume":"25","author":"G Grinblat","year":"2020","unstructured":"Grinblat G, Vlad D, Caruso A, Sanna M (2020) Evaluation of subtotal petrosectomy technique in difficult cases of cochlear implantation. Audiol Neurootol 25(6):323\u2013335. https:\/\/doi.org\/10.1159\/000507419Epub 2020 May 29. PMID: 32474562","journal-title":"Audiol Neurootol"},{"key":"9431_CR21","unstructured":"M. Sanna et.al Microsurgical Management of Middle Ear and Petrous Bone Cholesteatoma by Thieme - ISBN 978-3-13-000056"},{"issue":"10","key":"9431_CR22","doi-asserted-by":"publisher","first-page":"4427","DOI":"10.1007\/s00405-023-07959-1","volume":"280","author":"L Morelli","year":"2023","unstructured":"Morelli L, Fancello V, Gaino F, Cagliero G, Caruso A, Sanna M (2023) Cochlear implantation in single-sided deafness: a single-center experience of 138 cases. Eur Arch Otorhinolaryngol 280(10):4427\u20134432. https:\/\/doi.org\/10.1007\/s00405-023-07959-1Epub 2023 Apr 8. PMID: 37029803","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"9431_CR23","doi-asserted-by":"publisher","unstructured":"Ar\u00edstegui I, Aranguez G, Casqueiro JC, Guti\u00e9rrez-Triguero M, Pozo AD, Ar\u00edstegui M (2022) Subtotal Petrosectomy (SP) in Cochlear Implantation (CI): A Report of 92 Cases. Audiol Res 12(2):113\u2013125. https:\/\/doi.org\/10.3390\/audiolres12020014. PMID: 35314609","DOI":"10.3390\/audiolres12020014"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09431-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-025-09431-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09431-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T18:59:00Z","timestamp":1760381940000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-025-09431-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,15]]},"references-count":23,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["9431"],"URL":"https:\/\/doi.org\/10.1007\/s00405-025-09431-8","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,15]]},"assertion":[{"value":"27 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}