Related Experiment Video
Updated: Jun 17, 2026
Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
Medical and surgical complications in pediatric cochlear implantation
Natalie Loundon1, Marion Blanchard, Gilles Roger
1Service d'Oto-rhino-laryngologie Pédiatrique et de Chirurgie Cervico-faciale, Hôpital d'Enfants Armand-Trousseau, 26 Avenue du Dr Arnold Netter, 75012 Paris, France. natalie.loundon@trs.aphp.fr
Insights
Cochlear implantation (CI) complications in children are frequent, with trauma being a significant risk factor. Inner ear malformations also increase complication risk, necessitating tailored preventive strategies.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Neurosurgery
Background:
- Cochlear implantation (CI) is a vital auditory prosthetic for children with severe to profound hearing loss.
- Understanding the incidence and risk factors for CI complications is crucial for optimizing patient outcomes.
Purpose of the Study:
- To document the types and frequency of complications following cochlear implantation in pediatric patients.
- To identify risk factors associated with these complications, including age at implantation, trauma, and inner ear malformations.
Main Methods:
- A retrospective analysis of 434 pediatric patients (<16 years) who underwent cochlear implantation between 1990 and 2008.
- Complications were categorized as early or delayed, and major or minor.
- Statistical analysis (chi-squared test) was used to correlate complications with age at CI, local trauma, and inner ear malformations.
Main Results:
- 9.9% of patients (43/434) experienced complications, with 65.1% of these being delayed.
- Major complications (5.5%) included severe infections, device issues, meningitis, cholesteatoma, CSF leak, and electrode misplacement.
- Trauma to the mastoid area and inner ear malformations were significantly associated with major delayed and early minor complications, respectively (P < .001).
Conclusions:
- Complications following pediatric cochlear implantation are relatively common, with trauma being a primary contributing factor.
- Specific preventive measures are recommended for children with inner ear malformations.
- Younger age at implantation was not found to be a risk factor for complications in this cohort.
Objectives:
To report complications of cochlear implantation (CI) in children and to analyze risk factors.
Design:
Retrospective study from January 1, 1990, through April 30, 2008, with a mean follow-up of 5.5 years (range, 1 month to 17 years).
Setting:
Tertiary academic center.
Patients:
Four hundred thirty-four patients younger than 16 years. Mean age at CI was 4.7 (range, 0.6-16.0) years. Forty-one children (9.4%) underwent CI when younger than 24 months. Forty-three (9.9%) had inner ear malformations.
Main Outcome Measures:
Complications after CI, classified into early (0-8 days) or delayed (>8 days) and major or minor. Spontaneous failures of internal devices were excluded. Correlation to age at CI, local trauma, and inner ear malformations were analyzed using the chi(2) test.
Results:
Forty-three patients (9.9%) experienced complications. Delayed complications occurred in 28 patients (65.1%), with a mean delay of 2.2 (range, 0.1-8.4) years. Twenty-four patients (5.5%) had major complications, consisting of severe cutaneous infections (15 patients), magnet displacement (3), meningitis (2), cholesteatoma (2), cerebrospinal fluid leak (1), and electrode misplacement (1). Nineteen (4.4%) had minor complications, consisting of vertigo (9 patients), soft-tissue infection (5), persistent otitis media (4), and facial palsy (1). Complications led to reimplantation in 13 of the 43 patients (30.2%). Trauma to the mastoid area (14 patients) and inner ear malformations (51) were highly correlated with major delayed complications (P < .001) and early minor complications (P < .001), respectively. Young age at CI was not correlated with any type of complication.
Conclusions:
Complications of CI in children are common, with trauma as a major factor. Inner ear malformations should prompt specific preventive management. Cochlear implantation in young children did not appear to be a risk factor in this study.
