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Cochlear reimplantation in children: soft signs, symptoms and results
Susan Waltzman1, J Thomas Roland, Michael Waltzman
1New York University School of Medicine, New York, NY, USA. susan.waltzman@med.nyu.edu
Insights
Pediatric cochlear implant failures can be predicted by symptoms like pain and reduced performance. Reimplantation with new devices may require an adjustment period for optimal speech recognition.
Area of Science:
- Otolaryngology
- Biomedical Engineering
- Pediatric Audiology
Background:
- Cochlear implant device failures and reimplantation are primarily documented in adults.
- Understanding pediatric-specific failure precursors is crucial for timely intervention.
Purpose of the Study:
- To identify precursors of cochlear implant device failures in children.
- To evaluate the outcomes of cochlear reimplantation in pediatric patients.
Main Methods:
- Retrospective analysis of 27 pediatric cochlear reimplantations (1997-2003).
- Categorization of pre-failure symptoms and correlation with failure modes.
- Speech-recognition testing pre- and post-reimplantation.
Main Results:
- Pre-failure usage ranged from 0 to 12 years.
- Symptoms like pain, intermittence, reduced performance, and noise were linked to failures.
- Post-reimplantation performance with upgraded devices matched pre-failure levels after an adjustment period.
Conclusions:
- Specific complaints and reduced speech recognition indicate potential cochlear implant failure.
- Routine follow-up evaluations are essential for pediatric cochlear implant users.
- Reimplantation with newer technology necessitates an adjustment period for speech understanding recovery.
Objectives:
Cochlear implant device failures and reimplantation have mainly been reported on in adults. The purpose of this study was to isolate precursors of device failures and assess the effects of reimplantation in children.
Methods:
From 1997 to 2003, 27 children underwent cochlear reimplantation at our institution. The pre-failure complaints were categorized and correlated with actual failure modes and postimplantation results. Speech-recognition tests were used to evaluate pre- and post-reimplantation performance.
Results:
Pre-failure length of usage ranged from 0 to 12 years. Symptoms including pain, intermittence, reduced performance, noise and the need for frequent device adjustments were associated with device failures, although not with a particular mode of failure. Post reimplantation performance was equal to but not immediately better than pre-failure results in children who received upgraded devices.
Conclusions:
Specific complaints, frequent need for device adjustments and reduced speech recognition can be precursors to device failures, underscoring the need for routine follow-up evaluations. Reimplantation with newer technology does not guarantee improved speech understanding and often requires an adjustment period to reach pre-reimplantation levels.