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Updated: Apr 18, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Pain-only complaint about cochlear implant device: A five-patient pediatric experience
Insights
Pain at the cochlear implant (CI) receiver-stimulator site can be the only sign of device failure. Revision surgery resolved pain in most pediatric cases, highlighting the need for a CI pain registry.
Area of Science:
- Otolaryngology
- Biomedical Engineering
- Pediatric Audiology
Background:
- Pediatric cochlear implant (CI) surgeries are common, yet complications like receiver-stimulator site pain are infrequently reported.
- This case series examines five pediatric patients experiencing isolated pain at the CI receiver-stimulator site.
Observation:
- Pain onset varied from 2 to 16 years post-implantation and was unresponsive to medical therapy.
- Pain persisted even when the external device was off or not worn.
- Four patients had bilateral implants, but pain localized to only one receiver-stimulator.
Findings:
- Revision surgery successfully resolved pain in four out of five pediatric CI patients.
- Two explanted devices showed hermeticity loss and insulation failure.
- Post-revision, three of four patients experienced good outcomes with their replacement CI.
Implications:
- Isolated pain can be the sole indicator of cochlear implant device failure in pediatric patients.
- A standardized flowchart for managing CI-related pain and a global registry are recommended.
- Further research is needed to understand the underlying mechanisms of CI-induced pain.
Objectives:
To present the case histories and management of five pediatric patients who experienced pain at the receiver-stimulator site, but no other indication that the device was failing. Patients were from a sole-surgeon pediatric practice (600 + implant surgeries before June 2013; about even proportions of Advanced Bionics, Cochlear Corporation, and MED-EL devices).
Methods:
The University Institutional Review Board-approved review of sole-surgeon pediatric case series.
Results:
The onset of pain ranged from 2 to 16 years post implantation. Pain, not amenable to conventional medical therapy, was present regardless of whether or not the external appliance was 'on', or even being worn on the head. Four of the five patients were bilaterally implanted, but pain was only at one receiver-stimulator package. Clinical management ultimately included revision surgery in all five cases, with immediate resolution of the pain in four. For those four, the replacement cochlear implant (CI) performed well; the other patient fears pain if her replacement device is used, but continues enjoying her contralateral implant. At analysis by the company, two of five explanted devices exhibited problems: loss of hermeticity; insulation failure.
Discussion:
Though infrequently reported, pain-only complaint by a CI user is a challenging dilemma.
Conclusion:
Pain may be the sole clinical manifestation of cochlear implant device failure. We offer a flowchart for the care of CI patients with pain, encourage a worldwide registry of such cases, and offer ideas to try to understand better the problem.
