The Role of Cochlear Anatomy in Hearing Preservation After Cochlear Implantation in Adults: A Systematic Review
- 1Department of Otorhinolaryngology Ghent University Hospital Ghent Belgium
- 2Department of Diagnostic Sciences Ghent University Ghent Belgium
Abstract
Objective To evaluate the association between cochlear anatomical parameters and postoperative hearing preservation (HP) following cochlear implantation in adults with preoperative residual hearing (RH). Methods This systematic review followed PRISMA guidelines (PROSPERO: CRD420250630915). Embase, MEDLINE, PubMed, Scopus, and Web of Science were searched for studies published between 2010 and 2026. Eligible studies included adults (≥ 18 years) with preoperative RH undergoing cochlear implantation, assessed cochlear anatomy using computed tomography or magnetic resonance imaging, reported HP within 6 months postoperatively, and examined the relationship between cochlear anatomy parameter(s) and HP. Risk of bias was evaluated using the QUIPS tool. Data were synthesized narratively; where possible, a meta‐analysis using a random‐effects model was performed. Certainty of evidence was assessed using GRADE. Results Ten studies (487 implants) were included. Risk of bias was highest for study participation and confounding. Longer cochlear duct length and larger cochlear volume were suggested to be associated with better HP, though findings were inconsistent. Six studies examined angular insertion depth; four were pooled. Meta‐analysis indicated a small positive correlation (pooled r = 0.23; p = 0.004; 95% confidence interval: −0.14 to 0.54), suggesting poorer HP with deeper insertion, with moderate heterogeneity (I2 = 48.5%). Certainty of evidence for all outcomes was rated very low. Conclusion Cochlear anatomy may influence hearing preservation following cochlear implantation, with longer cochlear duct length and larger cochlear volume showing the most consistent associations with favorable outcomes. However, the certainty of evidence was very low, precluding firm conclusions regarding the predictive value of anatomical factors. Level of Evidence 3.
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BibTeX
@article{uzeel2026role,
title = {{The Role of Cochlear Anatomy in Hearing Preservation After Cochlear Implantation in Adults: A Systematic Review}},
author = {Bo Uzeel and Freya Swinnen and Veroniek Van Driessche and Dorien Ceuleers and Ingeborg Dhooge},
journal = {Laryngoscope Investigative Otolaryngology},
year = {2026},
month = oct,
doi = {10.1002/lio2.70571},
url = {https://doi.org/10.1002/lio2.70571},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Role of Cochlear Anatomy in Hearing Preservation After Cochlear Implantation in Adults: A Systematic Review
AU - Bo Uzeel
AU - Freya Swinnen
AU - Veroniek Van Driessche
AU - Dorien Ceuleers
AU - Ingeborg Dhooge
PY - 2026
DA - 2026/10/28
JO - Laryngoscope Investigative Otolaryngology
DO - 10.1002/lio2.70571
UR - https://doi.org/10.1002/lio2.70571
AB - Objective To evaluate the association between cochlear anatomical parameters and postoperative hearing preservation (HP) following cochlear implantation in adults with preoperative residual hearing (RH). Methods This systematic review followed PRISMA guidelines (PROSPERO: CRD420250630915). Embase, MEDLINE, PubMed, Scopus, and Web of Science were searched for studies published between 2010 and 2026. Eligible studies included adults (≥ 18 years) with preoperative RH undergoing cochlear implantation, assessed cochlear anatomy using computed tomography or magnetic resonance imaging, reported HP within 6 months postoperatively, and examined the relationship between cochlear anatomy parameter(s) and HP. Risk of bias was evaluated using the QUIPS tool. Data were synthesized narratively; where possible, a meta‐analysis using a random‐effects model was performed. Certainty of evidence was assessed using GRADE. Results Ten studies (487 implants) were included. Risk of bias was highest for study participation and confounding. Longer cochlear duct length and larger cochlear volume were suggested to be associated with better HP, though findings were inconsistent. Six studies examined angular insertion depth; four were pooled. Meta‐analysis indicated a small positive correlation (pooled r = 0.23; p = 0.004; 95% confidence interval: −0.14 to 0.54), suggesting poorer HP with deeper insertion, with moderate heterogeneity (I2 = 48.5%). Certainty of evidence for all outcomes was rated very low. Conclusion Cochlear anatomy may influence hearing preservation following cochlear implantation, with longer cochlear duct length and larger cochlear volume showing the most consistent associations with favorable outcomes. However, the certainty of evidence was very low, precluding firm conclusions regarding the predictive value of anatomical factors. Level of Evidence 3.
SN - 2378-8038
ER -