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Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
Low pediatric cochlear implant failure rate: contributing factors in large-volume practice
Antoine Eskander1, Karen A Gordon, Latif Kadhim
1Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 190 Elizabeth St, Toronto, Ontario, Canada. antoine.eskander@utoronto.ca
Archives of Otolaryngology--Head & Neck Surgery
|December 21, 2011
Summary
Cochlear implant (CI) reimplantation rates are low in children, with only 2.9% requiring reimplantation. Meningitis before CI surgery increases the risk of device failure, but speech outcomes are generally maintained after reimplantation.
Area of Science:
- Pediatric Otolaryngology
- Biomedical Engineering
- Auditory Implants
Background:
- Cochlear implantation (CI) is a vital treatment for pediatric hearing loss.
- Device fixation techniques, including suture to cortical bone, aim to improve CI longevity.
- Understanding CI failure and reimplantation (CIri) rates is crucial for optimizing pediatric audiological care.
Purpose of the Study:
- To evaluate the incidence of cochlear implant (CI) failure and CI reimplantation (CIri) in a pediatric population.
- To identify factors associated with CI failure and reimplantation.
- To assess speech perception outcomes following CI reimplantation.
Main Methods:
- Retrospective analysis of pediatric CI cases from 1990 to 2010 at a tertiary pediatric hospital.
- Analysis of 971 devices implanted in 738 children over 5575 implant-years.
- Assessment of surgical findings, device models, and speech perception scores (Pediatric Ranked Order Speech Perception, Phonetically Balanced Kindergarten) before and after CIri.
Main Results:
- A CIri rate of 2.9% was observed in children initially implanted at the center.
- Mean time to device failure was 61 months.
- A history of meningitis prior to CI was associated with an increased risk of device failure (20% of CIri cases).
- Most children maintained or improved speech perception after CIri, with only two showing significant decline.
Conclusions:
- Pediatric cochlear implantation demonstrates a very low rate of device failure and reimplantation.
- Meningitis preceding cochlear implantation is a significant risk factor for device failure.
- Reimplantation generally preserves or enhances speech perception abilities in pediatric CI recipients.