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Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
Impact to the head increases cochlear implant reimplantation rate in children
Jan Bernd Weise1, Joachim Muller-Deile, Goetz Brademann
1Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, Arnold-Heller-Str. 14, 24105 Kiel, Germany. jweise@hno.uni-kiel.de
Insights
Cochlear reimplantation in children, often due to head trauma, occurs at a higher rate than in adults. However, revision surgery is safe and does not negatively impact hearing performance.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Biomedical Engineering
Background:
- Cochlear implantation is a vital auditory prosthetic for children with severe to profound hearing loss.
- Device failure and complications necessitate reimplantation, particularly in pediatric populations.
Purpose of the Study:
- To evaluate the outcomes of cochlear implantation in pediatric patients.
- To identify causes and management strategies for cochlear reimplantation in children.
Main Methods:
- Retrospective review of 110 pediatric patients (<18 years) who underwent cochlear implantation.
- Analysis of demographics, complications, and reimplantation history for Nucleus and MED-EL devices.
Main Results:
- The pediatric reimplantation rate was 5.4%, significantly higher than the 0.8% in adults, primarily due to head trauma.
- Causes of reimplantation included traumatic device failure, incorrect electrode insertion, and infection.
- Post-revision performance showed no decline in auditory scores compared to pre-failure data.
Conclusions:
- Pediatric patients face a higher risk of cochlear reimplantation due to factors like head trauma during motor skill development.
- Surgical revision and reimplantation in children can be performed safely, maintaining or improving auditory performance outcomes.
Objective:
To describe the outcome of cochlear implantation in children and to discuss the cause and management of cochlear reimplantation.
Study Design:
Retrospective chart review.
Methods:
The medical records of 110 patients younger than 18 years of age, who underwent cochlear implantation at the Department of ORL, Head and Neck Surgery, of the University of Kiel, Germany, were reviewed for demographics, complications, and history of revision surgery. The patients had previously had implantation with either Nucleus (including the Contour) devices or MED-EL devices.
Results:
Length of use before cochlear explanation ranged from 4 days to 3.9 years. Reimplantation was caused by traumatic device failure, wrong electrode insertion and infection of implanted area. Results indicated a reimplantation rate of 5.4% in children compared to 0.8% in adults, mostly resulting from the greater risk of children receiving an impact to the head. Postoperative performance data showed no decrease in scores taken before failure.
Conclusions:
Though young children who are developing their motor skills are probably at greater risk of a cochlear reimplantation resulting from device failure following head trauma, surgical revision with reimplantation can be performed safely and without decrement to performance.