Cochlear re-implant rates in children: 20 years experience in a quaternary paediatric cochlear implant centre

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Pediatric Audiology

Background:

• Cochlear implantation is a vital treatment for pediatric hearing loss.
• Device explantation and re-implantation are significant concerns in pediatric cochlear implant (CI) care.
• Understanding the incidence and causes of explantation is crucial for improving long-term outcomes.

Purpose of the Study:

• To determine the incidence and causes of cochlear implant explantation and re-implantation in a pediatric population.
• To identify potential risk factors associated with device failure and explantation.
• To compare findings with existing literature on pediatric CI outcomes.

Main Methods:

• Retrospective case review of pediatric CI patients undergoing explantation/re-implantation.
• Analysis of data from a Quaternary pediatric Cochlear Implant (CI) Centre between 1992 and January 2013.
• Independent variables included age at implantation, etiology of deafness, CI manufacturer, and timing of explantation/re-implantation.

Main Results:

• A total of 778 pediatric cochlear implants were performed in 653 children.
• 40 implants (5.1%) failed in 38 patients, with device failure (2.8%) being the most common reason.
• Medical/surgical issues accounted for 2.3% of failures; mean time to explantation was 3 years 10 months.
• Known manufacturing defects/device recalls were identified as risk factors for device failure.

Conclusions:

• The incidence of pediatric cochlear implant explantation/re-implantation in this cohort is comparable to published data.
• Device failure is the primary driver for explantation in pediatric CI recipients.
• Etiology of deafness, specifically meningitis, did not emerge as an increased risk factor for explantation in this study population.