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Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations
Özgür Tarkan1, Ülkü Tuncer, Süleyman Özdemir
1Çukurova University Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery, Adana 01330, Turkey. ozgur_tarkan@yahoo.com
Insights
Pediatric cochlear implantation (CI) is safe with a 9% complication rate, including device failure and infections. Long-term follow-up is crucial for managing surgical complications in children.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Device Technology
Background:
- Cochlear implantation (CI) is a vital auditory prosthetic surgery for children with severe to profound hearing loss.
- Assessing complication rates and management strategies is essential for optimizing pediatric CI outcomes.
Purpose of the Study:
- To evaluate the incidence and types of complications following pediatric cochlear implantation (CI).
- To analyze the necessity for revision surgeries and medical interventions in children post-CI.
Main Methods:
- Retrospective analysis of 475 pediatric cochlear implantations performed between March 2000 and March 2012.
- Systematic review of all complications, including their causes, and subsequent management during a follow-up period of 5 months to 12 years.
Main Results:
- A total of 9% of patients (43/475) experienced complications, with 4.4% having major issues like device failure and meningitis.
- Minor complications, such as otitis media and wound infections, occurred in 4.6% of patients.
- Complications necessitated reimplantation in 13 patients and other revision surgeries in 7 patients.
Conclusions:
- Pediatric cochlear implantation demonstrates a low complication rate when performed by experienced surgeons.
- Continuous long-term follow-up is imperative for effective management and prevention of surgical complications in pediatric CI recipients.
Objective:
The purpose of this study is to assess complications occurring after cochlear implantation (CI) in children and to discuss revision surgeries and medical interventions occurring during follow-up.
Study Design:
Retrospective study of 475 consecutive pediatric cochlear implantations at a tertiary referral center.
Methods:
The patients (n = 475) who received cochlear implants in our institution between March 2000 and March 2012 were followed up (range, 5 months-12 years). All complications were systematically reviewed, and their causes were analyzed for prevention and therapy.
Results:
All children received unilateral CI. Mean age at implantation was 3 years 7 months (ranged from 10 months to 18 years). Forty-three patients (9%) experienced complications. Twenty-one patients (4.4%) had major complications, consisting of device failure (10 patients), flap necrosis (4 patients), meningitis (2 patients), electrode shifting (2 patients), hematoma (2 patients) and magnet migration (1 patient). Twenty-two (4.6%) had minor complications, consisting of acute otitis media (5 patients), skin lesion due to pressure reaction in contralateral ear during surgery (4 patients), flap swelling (3 patients), minor wound infection (3 patients), transient facial paralysis (2 patients), transient vertigo (2 patients), hematoma (1 patient), facial stimulation (1 patient), subcutaneous emphysema (1 patient). Complications led to reimplantation in 13 (30.2%) and other revision surgery in 7 (16.2%) of the 43 patients. One patient with meningitis cured with medical treatment and 22 patients with minor complications cured with either medical treatment or spontaneously.
Conclusions:
Cochlear implantation is a safe technique in experienced hands with a relatively low complication rate. Long term follow up is mandatory to minimize and control surgical complication.
