, Beaucoup de travaux ont étudié l'influence de la technique opératoire sur les performances de l'implant. Les crite?res les plus analysés sont la position du porte-électrodes, sa longueur et son angle d'insertion. Le nombre d'électrodes insérées et activées a également une influence positive sur les performances de l'implant 99, p.100

S. Dans-notre, l'insertion du porte-électrodes a été incomple?te pour 6 implantations (3.7%, n=162), avec un nombre d'électrodes non-insérées allant de 1 à 10. La moitié de ces cas présentaient une malformation ou une ossification cochléaires

, ans pour 4 de ces 6 implantations partielles. Seule l'insertion partielle avec 10 electrodes extra cochléaires était associée avec des mauvais résultats post-implantation (CAP<5)

É. Dans-notre, les enfants implantés en bilatéral avaient des meilleurs scores CAP et SIR au contrôle à 3 ans comparés aux autres enfants. Cependant, aucune différence significative n'a été retrouvée entre ces deux groupes

, En revanche, plus de complication ont été notées dans le groupe implantation bilatérale (9.1% vs 6.54%, hormis les pannes) et le deuxie?me implant n'avait pas d'effet significatif sur le seuil d'intelligibilité à 60dB en audiométrie vocale (listes mono et bisyllabiques)

, Ce dernier résultat est attendu puisque l'implantation bilatérale améliore avant tout la discrimination dans le bruit et la localisation spatiale. L'appréciation de ces avantages nécessite des tests spécifiques difficilement réalisables chez l'enfant

, Si une implantation cochléaire bilatérale séquentielle est réalisée, l'intervalle doit être assez court (le plus tôt possible) afin d'utiliser la période critique pour le développement de l'audition binaurale 101 . Si les intervalles sont plus longs, le gain auditif de l'oreille implantée tardivement et la performance auditive binaurale seront plus médiocres 102

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