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Surgical complications with the cochlear multiple-channel intracochlear implant: experience at Hannover and Melbourne
R L Webb1, E Lehnhardt, G M Clark
1Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia.
Insights
Cochlear implant surgery complications were reviewed in two centers. Most complications were minor, with wound breakdown requiring implant removal occurring in less than 1% of cases.
Area of Science:
- Otolaryngology
- Neurosurgery
- Biomedical Engineering
Background:
- Multiple-channel cochlear implantation is a complex surgical procedure.
- Understanding surgical complication rates is crucial for patient safety and procedural refinement.
Purpose of the Study:
- To report and analyze the surgical complications of multiple-channel cochlear implant operations.
- To compare complication rates between two distinct surgical centers.
Main Methods:
- Retrospective review of surgical complication data.
- Analysis of 153 cases from Hannover Medical University and 100 cases from the University of Melbourne Clinic.
Main Results:
- Major complications included wound breakdown, infection, electrode issues, tinnitus, and facial nerve stimulation.
- Wound breakdown requiring explantation occurred at 0.6% in Hannover and 1.0% in Melbourne.
- Overall complication rates were deemed acceptable at both institutions.
Conclusions:
- Surgical complications associated with multiple-channel cochlear implants are generally manageable.
- Minimizing wound breakdown can be achieved through careful surgical technique, including generous incisions and tension-free closure.
Abstract:
The surgical complications for the first 153 multiple-channel cochlear implant operations carried out at the Medizinische Hochschule in Hannover and the first 100 operations at the University of Melbourne Clinic, The Royal Victorian Eye and Ear Hospital, are presented. In the Hannover experience the major complications were wound breakdown, wound infection, electrode tie erosion through the external auditory canal, electrode slippage, a persistent increase in tinnitus, and facial nerve stimulation. The incidence of wound breakdown requiring removal of the package was 0.6% in Hannover and 1.0% in Melbourne. The complications for the operation at both clinics were at acceptable levels. It was considered that wound breakdown requiring implant removal could be kept to a minimum by making a generous incision and suturing the flap without tension.