To evaluate the spectral resolution achieved with a cochlear implant in users who were implanted using round window route electrode insertion versus a traditional cochleostomy technique.

Twenty-six patients were classified into two groups according to the surgical approach: one group (n = 13) underwent cochlear implantation via the round window technique and the other group (n = 13) underwent surgery via cochleostomy.

A statistically significant difference was found in spectral ripple discrimination scores between the round window and cochleostomy groups. The round window group performed almost two times better than the cochleostomy group. Differences between Turkish matrix sentence test scores were not statistically significant.

The spectral ripple discrimination scores of patients who had undergone round window cochlear implant electrode insertion were superior to those of patients whose cochlear implants were inserted using a classical cochleostomy technique.

Endoscopes provide a magnified view of the middle ear and visualisation of hidden areas. Otoendoscopes facilitate excellent visualisation of the round window niche during cochlear implantation.

To compare microscopic and endoscopic visualisation of the round window membrane during cochlear implantation in 20 patients.

Twenty patients who underwent cochlear implantation were included in the study. After maximum exposure of the round window, the accessibility of the round window membrane was graded according to the St Thomas Hospital classification, first by microscope and then by endoscope.

With the use of the endoscope, visualisation of the round window membrane improved in all the patients as compared to the microscope. The electrode array was inserted via a round window or extended round window approach in all but two cases; the latter cases required bony cochleostomy because of unfavourable anatomy.

The main benefit of endoscope-assisted cochlear implantation is improved visibility of the round window region.