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Pediatric cochlear implantation: associated with minimal postoperative pain and dizziness
Catherine S Birman1, William P R Gibson, Elizabeth J Elliott
1*Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney; †Sydney Children's Hospital Network (Children's Hospital at Westmead); ‡The Sydney Cochlear Implant Centre, NSW; §Department of Linguistics, Faculty of Human Sciences, Macquarie University; and ∥Sydney Medical School, University of Sydney, Australia.
Insights
Cochlear implant surgery in children is well-tolerated, with minimal pain and dizziness reported within the first week. This finding aids in better family counseling for the cochlear implantation procedure.
Area of Science:
- Pediatric Otolaryngology
- Neurosurgery
- Audiology
Background:
- Cochlear implantation is a common surgical intervention for pediatric hearing loss.
- Understanding postoperative pain and dizziness is crucial for patient management and family counseling.
Purpose of the Study:
- To prospectively evaluate surgical pain, analgesia use, and postoperative dizziness in children following cochlear implantation.
- To provide data for improved counseling of families and children undergoing this procedure.
Main Methods:
- Prospective study at a tertiary referral hospital involving children aged 0-16 years undergoing cochlear implant surgery.
- Data on analgesia use and dizziness were collected via direct questioning at the 1-week postoperative follow-up.
Main Results:
- 61 children were analyzed; average paracetamol use was 1.9 days post-discharge.
- Bilateral simultaneous surgery and younger age (0-12 months) correlated with longer paracetamol use.
- 8% of children reported slight dizziness; no severe dizziness or unsteadiness was observed. Children with large vestibular aqueducts showed a higher incidence of slight unsteadiness.
Conclusions:
- Cochlear implant surgery is generally well-tolerated in the pediatric population.
- The study provides valuable insights for counseling families regarding the expected postoperative experience.
Objective:
To prospectively document the surgical pain, assessing analgesia use as a proxy, and postoperative dizziness in children over the first week after cochlear implantation.
Study Design:
Prospective.
Setting:
Tertiary referral hospital and cochlear implant program.
Patients:
Children aged 0 to 16 years inclusive undergoing cochlear implant surgery, who returned to see the primary surgeon for the postoperative 1-week follow-up appointment.
Interventions:
One-week postoperative collection of data via direct questioning of parents and children.
Main Outcome Measures:
Analgesia use, duration of analgesia use and dizziness (nil, slight, or moderate), type of surgery, and radiologic findings.
Results:
Data were available for 61 of 98 children aged 5 months to 15 years. Children underwent first side implant (n = 27), sequential second side implant (n = 15), bilateral simultaneous (n = 16), and explant reimplantation (n = 3). On average, children used paracetamol for only 1.9 days after discharge from the hospital. Longer average paracetamol use was associated with bilateral simultaneous surgery (3.3 d after discharge from the hospital) and also the younger age group of 0 to 12 months (3.2 d). Slight dizziness was reported by 8% of all children at 1 week postsurgery.No child had marked dizziness or unsteadiness. Four children had large vestibular aqueducts on radiology scans, two (50%) of these children has slight unsteadiness at 1 week postoperatively.
Conclusion:
Our study shows cochlear implant surgery is well tolerated by children. This information enables better counseling of families and children considering cochlear implantation.
