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Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
Pediatric cochlear implant revision surgery and reimplantation: an analysis of 957 cases
Yüksel Olgun1, Asuman Feda Bayrak1, Tolgahan Catli1
1Izmir Bozyaka Teaching and Research Hospital, Department of Otorhinolaryngology, Izmir, Turkey.
Insights
Pediatric cochlear implant (CI) complications, including surgical issues and device failures, often necessitate revision surgery or reimplantation. Experienced surgeons are crucial for successful outcomes, aiming for performance comparable to primary implants.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Biomedical Engineering
Background:
- Cochlear implantation (CI) is a vital treatment for pediatric hearing loss.
- Revision surgeries and reimplantations address complications and device failures in pediatric CI patients.
- Understanding challenges in pediatric CI is crucial for improving long-term outcomes.
Purpose of the Study:
- To evaluate causes and risk factors for complications in pediatric cochlear implant surgery.
- To assess prevention strategies and difficulties during revision cochlear implant surgery and reimplantation.
- To analyze outcomes of revision and reimplantation surgeries in children.
Main Methods:
- Retrospective evaluation of 957 pediatric CI patients (under 18) implanted between 1998 and 2012.
- Systematic review of 18 referred CI complication cases in the same age group.
- Analysis of surgical complications, device-related problems, and outcomes of revision/reimplantation surgeries.
Main Results:
- A total of 80 complications were evaluated, including 26 surgical and 36 device-related issues.
- 19 revision surgeries were performed, with 4 failures; 48 cases underwent reimplantation, 4 after failed revisions.
- 46 reimplantations were single-stage, 5 required two stages; 1 implant was extracted, and 1 contralateral implant was placed.
Conclusions:
- Pediatric cochlear implant complications, encompassing surgical and device issues, frequently require revision or reimplantation.
- Device failures necessitate ongoing management, while surgical complications may decrease with surgeon experience.
- Revision surgery and reimplantation demand specialized care from experienced surgeons to achieve outcomes comparable to primary implants.
Objective:
In this study causes, risk factors, prevention strategies, diffuculties encountered during revision cochlear implant surgery, reimplantation in pediatric age group were evaluated.
Methods:
Charts of 957 CI patients younger than 18 years of age implanted at Izmir Bozyaka Teaching and Research Hospital between 1998 and July 2012 and 18 referred CI complications at same age group were retrospectively evaluated. Revision and reimplantation surgeries were systematically reviewed.
Results:
We encountered 26 surgical complications in 24 patients and 36 device related problems in 36 patients. Eighteen referred cases including 7 surgical complications and 11 device related problems were also evaluated. A total number of 80 complications were evaluated. In 11 cases conservative management was successful, 19 revision surgery was performed but we failed in 4 cases. We reimplanted 48 cases and 4 additional cases were implanted after failed revision surgery. Implant was extracted in one case. In one case we could implant the other side. Forty-six of reimplantations were done in one stage surgery, 5 cases required second stage surgery.
Conclusions:
Surgical complications and device related problems of cochlear implantation may be different in children and majority of them require revision surgery or reimplantation. Although surgical problems leading to revision surgery and reimplantation are expected to diminish by experience every center has to deal with device failures. Both revision surgery and reimplantation require extra care and it should be better carried out by experienced surgeons. Implant performances are expected to be comparable with primary implantations.
