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Updated: Jul 1, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Clinical results in paediatric cochlear implantation
Emmanuel A M Mylanus1, Paul van den Broek
1Department of Otorhinolaryngology, University Medical Centre St Radboud, Nijmegen, The Netherlands.
Insights
Paediatric cochlear implantation in 137 children revealed low major complication rates. Postmeningitic deafness presented challenges like cochlear ossification, but surgical techniques minimized risks.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Neurosurgery
Background:
- Paediatric cochlear implantation is a complex procedure.
- Postmeningitic deafness poses unique surgical challenges due to cochlear ossification.
- Evaluating peri- and postoperative complications is crucial for optimizing outcomes.
Purpose of the Study:
- To assess the surgical aspects of paediatric cochlear implantation.
- To identify and analyze peri- and postoperative complications in this patient group.
- To evaluate the impact of surgical techniques on complication rates.
Main Methods:
- Retrospective review of 137 consecutive paediatric cochlear implantation cases.
- Detailed analysis of intraoperative and postoperative complications.
- Specific evaluation of cases with postmeningitic deafness and cochlear ossification.
Main Results:
- 60% of cochleae in postmeningitic deafness cases showed ossification, requiring modified electrode insertion in some.
- Major intraoperative complications included CSF gusher (3), exposed carotid (1), and dura leak (1).
- Major postoperative flap complications occurred in 1.4% of patients; reimplantation or revision surgery was needed in a few cases.
Conclusions:
- Paediatric cochlear implantation can be performed with a low overall rate of major complications.
- Surgical techniques, including small retroauricular incisions, effectively reduce flap-related issues.
- Careful management is necessary for cases with cochlear ossification, particularly in postmeningitic deafness.
Abstract:
Surgical aspects of paediatric cochlear implantation and peri- and postoperative complications were evaluated in 137 consecutive patients. In 52 children with postmeningitic deafness, 60% of the cochleae showed ossification of some degree at surgery. In eight patients, this led to a partial insertion of the electrode array; in two patients a double array was used. Major intraoperative complications included CSF gusher in three, exposed carotid in one and a dura leak in another child. Major postoperative flap complications were encountered in two children with large skin flaps (1.4%). Three children underwent a reimplantation and one child required revision surgery for cholesteatoma at the implanted ear. The use of a small retroauricular incision has reduced the number of flap-related complications. Overall, the occurrence of major complications was low.