{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T22:53:32Z","timestamp":1781909612484,"version":"3.54.5"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215123000609_sec_a1\"><jats:title>Objective<\/jats:title><jats:p>This study aimed to determine if pre-operative radiological scoring can reliably predict intra-operative difficulty and final cochlear electrode position in patients with advanced otosclerosis.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000609_sec_a2\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>A retrospective cohort study of advanced otosclerosis patients who underwent cochlear implantation (<jats:italic>n =<\/jats:italic> 48, 52 ears) was compared with a larger cohort of post-lingually deaf adult patients (<jats:italic>n =<\/jats:italic> 1414) with bilateral hearing loss and normal cochlear anatomy. Pre-operative imaging for advanced otosclerosis patients and final electrode position were scored and correlated with intra-operative difficulty and speech outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000609_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Advanced otosclerosis patients benefit significantly from cochlear implantation. Mean duration of deafness was longer in the advanced otosclerosis group (19.5 <jats:italic>vs<\/jats:italic> 14.3 years; <jats:italic>p<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000609_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>Anatomical changes in advanced otosclerosis can result in increased difficulty of surgery. Evidence of pre-operative cochlear luminal changes was associated with intra-operative difficult insertion and final non-scala tympani position. Nearly all electrodes implanted in the advanced otosclerosis cohort were peri-modiolar. 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