{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:31:59Z","timestamp":1790163119904,"version":"4.1.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Advanced Bionics"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trials"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In order to preserve residual hearing in patients with sensorineural hearing loss (SNHL) who receive a cochlear implant (CI), insertion trauma to the delicate structures of the cochlea needs to be minimized. The surgical approach comprises the conventional mastoidectomy-posterior tympanotomy (MPT) to arrive at the middle ear, followed by either a cochleostomy (CO) or the round window (RW) approach. Both techniques have their benefits and disadvantages. Another important aspect in structure preservation is the design of the electrode array. Two different designs are used: a \u201cstraight\u201d lateral wall lying electrode array (LW) or a \u201cpre-curved\u201d perimodiolar lying electrode array (PM). Interestingly, until now, the best surgical approach and design of the implant is uncertain. Our hypothesis is that there is a difference in hearing preservation outcomes between the four possible treatment options.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We designed a monocenter, multi-arm, randomized controlled trial to compare insertion trauma between four groups of patients, with each group having a unique combination of an electrode array type (LW or PM) and surgical approach (RW or CO). In total, 48 patients will be randomized into one of these four intervention groups. Our primary objective is the comparison of postoperative hearing preservation between these four groups. Secondly, we aim to assess structure preservation (i.e., scalar translocation, with basilar membrane disruption or tip fold-over of array) for each group. Thirdly, we will compare objective outcomes of hearing and structure preservation by way of electrocochleography (ECochG).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>Cochlear implantation by way of a cochleostomy or round window approach, using different electrode array types, is the standard medical care for patients with severe to profound bilateral sensorineural hearing loss, as it is a relatively simple and low-risk procedure that greatly benefits patients. However, loss of residual hearing remains a problem. This trial is the first randomized controlled trial that evaluates the effect of cochlear insertion trauma of several CI treatment options on hearing preservation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>Netherlands Trial Register (NTR) <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.trialregister.nl\">NL8586<\/jats:ext-link>. Registered on 4 May 2020. Retrospectively registered; 3\/48 participants were included before registration.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13063-021-05878-2","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T12:07:21Z","timestamp":1639051641000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluating cochlear insertion trauma and hearing preservation after cochlear implantation (CIPRES): a study protocol for a randomized single-blind controlled trial"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-0681","authenticated-orcid":false,"given":"Saad","family":"Jwair","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf A.","family":"Boerboom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huib","family":"Versnel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Stokroos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans G. X. M.","family":"Thomeer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"issue":"11","key":"5878_CR1","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.1002\/ar.22580","volume":"295","author":"AA Eshraghi","year":"2012","unstructured":"Eshraghi AA, Nazarian R, Telischi FF, Rajguru SM, Truy E, Gupta C. The cochlear implant: historical aspects and future prospects. Anat Rec (Hoboken). 2012;295(11):1967\u201380. https:\/\/doi.org\/10.1002\/ar.22580.","journal-title":"Anat Rec (Hoboken)."},{"issue":"2","key":"5878_CR2","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1097\/01.aud.0000444781.15858.f1","volume":"35","author":"H Skarzynski","year":"2014","unstructured":"Skarzynski H, Lorens A, Matusiak M, Porowski M, Skarzynski PH, James CJ. Cochlear implantation with the nucleus slim straight electrode in subjects with residual low-frequency hearing. Ear and hearing. 2014;35(2):e33\u201343. https:\/\/doi.org\/10.1097\/01.aud.0000444781.15858.f1.","journal-title":"Ear and hearing."},{"issue":"4","key":"5878_CR3","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1097\/AUD.0b013e31827e8163","volume":"34","author":"RH Gifford","year":"2013","unstructured":"Gifford RH, Dorman MF, Skarzynski H, Lorens A, Polak M, Driscoll CL, et al. Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments. Ear Hear. 2013;34(4):413\u201325. https:\/\/doi.org\/10.1097\/AUD.0b013e31827e8163.","journal-title":"Ear Hear."},{"issue":"2","key":"5878_CR4","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1097\/mao.0b013e318163746","volume":"29","author":"A Buechner","year":"2008","unstructured":"Buechner A, Brendel M, Krueger B, Frohne-Buchner C, Nogueira W, Edler B, et al. Current steering and results from novel speech coding strategies. Otol Neurotol. 2008;29(2):203\u20137. https:\/\/doi.org\/10.1097\/mao.0b013e318163746.","journal-title":"Otol Neurotol."},{"issue":"Suppl 1","key":"5878_CR5","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1159\/000095608","volume":"11","author":"KE Gfeller","year":"2006","unstructured":"Gfeller KE, Olszewski C, Turner C, Gantz B, Oleson J. Music perception with cochlear implants and residual hearing. Audiol Neurootol. 2006;11(Suppl 1):12\u20135. https:\/\/doi.org\/10.1159\/000095608.","journal-title":"Audiol Neurootol."},{"issue":"4","key":"5878_CR6","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1097\/MAO.0b013e318288643e","volume":"34","author":"S Havenith","year":"2013","unstructured":"Havenith S, Lammers MJW, Tange RA, Trabalzini F. della Volpe A, van der Heijden GJMG, et al. Hearing preservation surgery: cochleostomy or round window approach? A systematic review. Otol Neurotol. 2013;34(4):667\u201374. https:\/\/doi.org\/10.1097\/MAO.0b013e318288643e.","journal-title":"Otol Neurotol."},{"issue":"Suppl 6","key":"5878_CR7","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1002\/lary.24728","volume":"124","author":"GB Wanna","year":"2014","unstructured":"Wanna GB, Noble JH, Carlson ML, Gifford RH, Dietrich MS, Haynes DS, et al. Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes. Laryngoscope. 2014;124(Suppl 6):S1\u20137. https:\/\/doi.org\/10.1002\/lary.24728.","journal-title":"Laryngoscope."},{"issue":"8","key":"5878_CR8","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1097\/MAO.0000000000000829","volume":"36","author":"GB Wanna","year":"2015","unstructured":"Wanna GB, Noble JH, Gifford RH, Dietrich MS, Sweeney AD, Zhang D, et al. Impact of intrascalar electrode location, electrode type, and angular insertion depth on residual hearing in cochlear implant patients: preliminary results. Otol Neurotol. 2015;36(8):1343\u20138. https:\/\/doi.org\/10.1097\/MAO.0000000000000829.","journal-title":"Otol Neurotol."},{"issue":"9","key":"5878_CR9","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1080\/00016489.2018.1478127","volume":"138","author":"XT Fan","year":"2018","unstructured":"Fan XT, Xia M, Wang Z, Zhang H, Liu CC, Wang N, et al. Comparison of electrode position between round window and cochleostomy inserting approaches among young children: a cone-beam computed tomography study. Acta Oto-Laryngol. 2018;138(9):815\u201321. https:\/\/doi.org\/10.1080\/00016489.2018.1478127.","journal-title":"Acta Oto-Laryngol."},{"issue":"2","key":"5878_CR10","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1097\/MAO.0000000000002083","volume":"40","author":"C Snels","year":"2019","unstructured":"Snels C, IntHout J, Mylanus E, Huinck W, Dhooge I. Hearing preservation in cochlear implant surgery: a meta-analysis. Otol Neurotol. 2019;40(2):145\u201353. https:\/\/doi.org\/10.1097\/MAO.0000000000002083.","journal-title":"Otol Neurotol."},{"issue":"3","key":"5878_CR11","doi-asserted-by":"publisher","first-page":"e168","DOI":"10.1097\/AUD.0000000000000394","volume":"38","author":"E Avci","year":"2017","unstructured":"Avci E, Nauwelaers T, Hamacher V, Kral A. Three-dimensional force profile during cochlear implantation depends on individual geometry and insertion trauma. Ear Hear. 2017;38(3):e168\u2013e79. https:\/\/doi.org\/10.1097\/AUD.0000000000000394.","journal-title":"Ear Hear."},{"issue":"Suppl 1","key":"5878_CR12","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000095611","volume":"11","author":"B Escud\u00e9","year":"2006","unstructured":"Escud\u00e9 B, James C, Deguine O, Cochard N, Eter E, Fraysse B. The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes. Audiol Neurootol. 2006;11(Suppl 1):27\u201333. https:\/\/doi.org\/10.1159\/000095611.","journal-title":"Audiol Neurootol."},{"issue":"Suppl 1","key":"5878_CR13","doi-asserted-by":"publisher","first-page":"S8","DOI":"10.1179\/146701011X13001035752174","volume":"12","author":"H Rask-Andersen","year":"2011","unstructured":"Rask-Andersen H, Erixon E, Kinnefors A, Lowenheim H, Schrott-Fischer A, Liu W. Anatomy of the human cochlea--implications for cochlear implantation. Cochlear Implants Int. 2011;12(Suppl 1):S8\u201313. https:\/\/doi.org\/10.1179\/146701011X13001035752174.","journal-title":"Cochlear Implants Int."},{"issue":"6","key":"5878_CR14","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/lio2.42","volume":"1","author":"BP O'Connell","year":"2016","unstructured":"O'Connell BP, Hunter JB, Wanna GB. The importance of electrode location in cochlear implantation. Laryngoscope Investig Otolaryngol. 2016;1(6):169\u201374. https:\/\/doi.org\/10.1002\/lio2.42.","journal-title":"Laryngoscope Investig Otolaryngol."},{"issue":"3","key":"5878_CR15","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1097\/AUD.0b013e3182741aa7","volume":"34","author":"LK Holden","year":"2013","unstructured":"Holden LK, Finley CC, Firszt JB, Holden TA, Brenner C, Potts LG, et al. Factors affecting open-set word recognition in adults with cochlear implants. Ear Hear. 2013;34(3):342\u201360. https:\/\/doi.org\/10.1097\/AUD.0b013e3182741aa7.","journal-title":"Ear Hear."},{"issue":"11","key":"5878_CR16","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1017\/S0022215118001871","volume":"132","author":"C Shaul","year":"2018","unstructured":"Shaul C, Dragovic AS, Stringer AK, O'Leary SJ, Briggs RJ. Scalar localisation of peri-modiolar electrodes and speech perception outcomes. J Laryngol Otol. 2018;132(11):1000\u20136. https:\/\/doi.org\/10.1017\/S0022215118001871.","journal-title":"J Laryngol Otol."},{"issue":"8","key":"5878_CR17","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1097\/MAO.0000000000001125","volume":"37","author":"BP O'Connell","year":"2016","unstructured":"O'Connell BP, Cakir A, Hunter JB, Francis DO, Noble JH, Labadie RF, et al. Electrode location and angular insertion depth are predictors of audiologic outcomes in cochlear implantation. Otol Neurotol. 2016;37(8):1016\u201323. https:\/\/doi.org\/10.1097\/MAO.0000000000001125.","journal-title":"Otol Neurotol."},{"issue":"5","key":"5878_CR18","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1159\/000448581","volume":"21","author":"MA van der Jagt","year":"2016","unstructured":"van der Jagt MA, Briaire JJ, Verbist BM, Frijns JH. Comparison of the hiFocus mid-Scala and hiFocus 1j electrode array: angular insertion depths and speech perception outcomes. Audiol Neurootol. 2016;21(5):316\u201325. https:\/\/doi.org\/10.1159\/000448581.","journal-title":"Audiol Neurootol."},{"issue":"3","key":"5878_CR19","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1159\/000377616","volume":"20","author":"KS van der Marel","year":"2015","unstructured":"van der Marel KS, Briaire JJ, Verbist BM, Muurling TJ, Frijns JH. The influence of cochlear implant electrode position on performance. Audiol Neurootol. 2015;20(3):202\u201311. https:\/\/doi.org\/10.1159\/000377616.","journal-title":"Audiol Neurootol."},{"issue":"9","key":"5878_CR20","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1097\/MAO.0000000000001951","volume":"39","author":"JE Fabie","year":"2018","unstructured":"Fabie JE, Keller RG, Hatch JL, Holcomb MA, Camposeo EL, Lambert PR, et al. Evaluation of outcome variability associated with lateral wall, mid-scalar, and perimodiolar electrode arrays when controlling for preoperative patient characteristics. Otol Neurotol. 2018;39(9):1122\u20138. https:\/\/doi.org\/10.1097\/MAO.0000000000001951.","journal-title":"Otol Neurotol."},{"issue":"5","key":"5878_CR21","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1097\/MAO.0000000000002189","volume":"40","author":"M Moran","year":"2019","unstructured":"Moran M, Vandali A, Briggs RJS, Dettman S, Cowan RSC, Dowell RC. Speech perception outcomes for adult cochlear implant recipients using a lateral wall or perimodiolar array. Otol Neurotol. 2019;40(5):608\u201316. https:\/\/doi.org\/10.1097\/MAO.0000000000002189.","journal-title":"Otol Neurotol."},{"issue":"2","key":"5878_CR22","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1097\/MAO.0000000000000603","volume":"36","author":"J Doshi","year":"2015","unstructured":"Doshi J, Johnson P, Mawman D, Green K, Bruce IA, Freeman S, et al. Straight versus modiolar hugging electrodes: does one perform better than the other? Otol Neurotol. 2015;36(2):223\u20137. https:\/\/doi.org\/10.1097\/MAO.0000000000000603.","journal-title":"Otol Neurotol."},{"issue":"5","key":"5878_CR23","doi-asserted-by":"publisher","first-page":"466","DOI":"10.3109\/00016489.2014.993090","volume":"135","author":"J Zou","year":"2015","unstructured":"Zou J, Lahelma J, Koivisto J, Dhanasingh A, Jolly C, Aarnisalo A, et al. Imaging cochlear implantation with round window insertion in human temporal bones and cochlear morphological variation using high-resolution cone beam CT. Acta Otolaryngol. 2015;135(5):466\u201372. https:\/\/doi.org\/10.3109\/00016489.2014.993090.","journal-title":"Acta Otolaryngol."},{"issue":"8","key":"5878_CR24","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1097\/MAO.0000000000000295","volume":"35","author":"SR Saeed","year":"2014","unstructured":"Saeed SR, Selvadurai D, Beale T, Biggs N, Murray B, Gibson P, et al. The use of cone-beam computed tomography to determine cochlear implant electrode position in human temporal bones. Otol Neurotol. 2014;35(8):1338\u201344. https:\/\/doi.org\/10.1097\/MAO.0000000000000295.","journal-title":"Otol Neurotol."},{"issue":"3","key":"5878_CR25","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1080\/00016489.2016.1227477","volume":"137","author":"I Mosnier","year":"2017","unstructured":"Mosnier I, C\u00e9l\u00e9rier C, Bensimon JL, de Seta D, Sterkers O, Nguyen Y, et al. Cone beam computed tomography and histological evaluations of a straight electrode array positioning in temporal bones. Acta Otolaryngol. 2017;137(3):229\u201334. https:\/\/doi.org\/10.1080\/00016489.2016.1227477.","journal-title":"Acta Otolaryngol."},{"issue":"9","key":"5878_CR26","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1097\/MAO.0b013e31826dbc80","volume":"33","author":"B Choudhury","year":"2012","unstructured":"Choudhury B, Fitzpatrick DC, Buchman CA, Wei BP, Dillon MT, He S, et al. Intraoperative round window recordings to acoustic stimuli from cochlear implant patients. Otol Neurotol. 2012;33(9):1507\u201315. https:\/\/doi.org\/10.1097\/MAO.0b013e31826dbc80.","journal-title":"Otol Neurotol."},{"issue":"7","key":"5878_CR27","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1097\/MAO.0000000000000768","volume":"36","author":"A Dalbert","year":"2015","unstructured":"Dalbert A, Sim JH, Gerig R, Pfiffner F, Roosli C, Huber A. Correlation of electrophysiological properties and hearing preservation in cochlear implant patients. Otol Neurotol. 2015;36(7):1172\u201380. https:\/\/doi.org\/10.1097\/MAO.0000000000000768.","journal-title":"Otol Neurotol."},{"issue":"4","key":"5878_CR28","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1097\/AUD.0000000000000659","volume":"40","author":"CK Giardina","year":"2019","unstructured":"Giardina CK, Brown KD, Adunka OF, Buchman CA, Hutson KA, Pillsbury HC, et al. Intracochlear electrocochleography: response patterns during cochlear implantation and hearing preservation. Ear Hear. 2019;40(4):833\u201348. https:\/\/doi.org\/10.1097\/AUD.0000000000000659.","journal-title":"Ear Hear."},{"issue":"3","key":"5878_CR29","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1097\/AUD.0000000000000630","volume":"40","author":"TE Fontenot","year":"2019","unstructured":"Fontenot TE, Giardina CK, Dillon M, Rooth MA, Teagle HF, Park LR, et al. Residual cochlear function in adults and children receiving cochlear implants: correlations with speech perception outcomes. Ear Hear. 2019;40(3):577\u201391. https:\/\/doi.org\/10.1097\/AUD.0000000000000630.","journal-title":"Ear Hear."},{"key":"5878_CR30","doi-asserted-by":"publisher","unstructured":"Snel-Bongers J, Netten AP, Boermans PBM, Rotteveel LJC, Briaire JJ, Frijns JHM. Evidence-Based InclusionCriteria for Cochlear Implantation in Patients With Postlingual Deafness. Ear Hear. 2018;39(5):1008\u20131014. https:\/\/doi.org\/10.1097\/AUD.0000000000000568.","DOI":"10.1097\/AUD.0000000000000568"},{"issue":"sup564","key":"5878_CR31","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3109\/00016489.2013.869059","volume":"564","author":"H Skarzynski","year":"2013","unstructured":"Skarzynski H, van de Heyning P, Agrawal S, Arauz SL, Atlas M, Baumgartner W, et al. Towards a consensus on a hearing preservation classification system. Acta Otolaryngol Suppl. 2013;564(sup564):3\u201313. https:\/\/doi.org\/10.3109\/00016489.2013.869059.","journal-title":"Acta Otolaryngol Suppl."},{"issue":"2","key":"5878_CR32","doi-asserted-by":"publisher","first-page":"63","DOI":"10.5624\/isd.2013.43.2.63","volume":"43","author":"G Li","year":"2013","unstructured":"Li G. Patient radiation dose and protection from cone-beam computed tomography. Imaging Sci Dent. 2013;43(2):63\u20139. https:\/\/doi.org\/10.5624\/isd.2013.43.2.63.","journal-title":"Imaging Sci Dent."},{"issue":"10","key":"5878_CR33","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1007\/s11547-018-0910-7","volume":"123","author":"C Nardi","year":"2018","unstructured":"Nardi C, Salerno S, Molteni R, Occhipinti M, Grazzini G, Norberti N, et al. Radiation dose in non-dental cone beam CT applications: a systematic review. Radiol Med. 2018;123(10):765\u201377. https:\/\/doi.org\/10.1007\/s11547-018-0910-7.","journal-title":"Radiol Med."},{"issue":"6","key":"5878_CR34","doi-asserted-by":"publisher","first-page":"333","DOI":"10.5334\/jbr-btr.453","volume":"96","author":"JW Casselman","year":"2013","unstructured":"Casselman JW, Gieraerts K, Volders D, Delanote J, Mermuys K, De Foer B, et al. Cone beam CT: non-dental applications. JBR-BTR. 2013;96(6):333\u201353. https:\/\/doi.org\/10.5334\/jbr-btr.453.","journal-title":"JBR-BTR."},{"issue":"3","key":"5878_CR35","doi-asserted-by":"publisher","first-page":"e92","DOI":"10.1097\/AUD.0000000000000009","volume":"35","author":"WR Drennan","year":"2014","unstructured":"Drennan WR, Anderson ES, Won JH, Rubinstein JT. Validation of a clinical assessment of spectral-ripple resolution for cochlear implant users. Ear Hear. 2014;35(3):e92\u20138. https:\/\/doi.org\/10.1097\/AUD.0000000000000009.","journal-title":"Ear Hear."},{"issue":"9","key":"5878_CR36","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1097\/MAO.0000000000001917","volume":"39","author":"JG Manjaly","year":"2018","unstructured":"Manjaly JG, Nash R, Ellis W, Britz A, Lavy JA, Shaida A, et al. Hearing preservation with standard length electrodes in pediatric cochlear implantation. Otol Neurotol. 2018;39(9):1109\u201314. https:\/\/doi.org\/10.1097\/MAO.0000000000001917.","journal-title":"Otol Neurotol."},{"issue":"Suppl 2","key":"5878_CR37","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1007\/s00106-018-0532-3","volume":"66","author":"T Rader","year":"2018","unstructured":"Rader T, Bohnert A, Matthias C, Koutsimpelas D, Kainz MA, Strieth S. Hearing preservation in children with electric-acoustic stimulation after cochlear implantation: outcome after electrode insertion with minimal insertion trauma. HNO. 2018;66(Suppl 2):56\u201362. https:\/\/doi.org\/10.1007\/s00106-018-0532-3.","journal-title":"HNO."},{"issue":"4","key":"5878_CR38","doi-asserted-by":"publisher","first-page":"e373","DOI":"10.1097\/MAO.0000000000002170","volume":"40","author":"C Sierra","year":"2019","unstructured":"Sierra C, Calderon M, Barcena E, Tisaire A, Raboso E. Preservation of residual hearing after cochlear implant surgery with deep insertion electrode arrays. Otol Neurotol. 2019;40(4):e373\u2013e80. https:\/\/doi.org\/10.1097\/MAO.0000000000002170.","journal-title":"Otol Neurotol."}],"container-title":["Trials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13063-021-05878-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13063-021-05878-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13063-021-05878-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T12:14:37Z","timestamp":1639052077000},"score":1,"resource":{"primary":{"URL":"https:\/\/trialsjournal.biomedcentral.com\/articles\/10.1186\/s13063-021-05878-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["5878"],"URL":"https:\/\/doi.org\/10.1186\/s13063-021-05878-2","relation":{},"ISSN":["1745-6215"],"issn-type":[{"value":"1745-6215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"13 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study will be conducted according to the principles of the 64th WMA General Assembly in Fortaleza (Brazil, October 2013) and in accordance with the Medical Research Involving Human Participants Act (WMO).This research protocol was approved by the Institutional Review Board (IRB) of the UMC Utrecht (METC 19-700, version 3, 14-01-2020). Written, informed consent to participate will be obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate {24}"}},{"value":"See supplementary materials for the IC form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication {32}"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests {28}"}}],"article-number":"895"}}