Outcomes after cochlear reimplantation in children

Area of Science:

• Otolaryngology
• Audiology
• Neurosurgery

Background:

• Cochlear implantation is a standard procedure for prelingual deafness.
• Reimplantation has become more frequent due to device malfunctions and medical/surgical complications.
• Assessing auditory outcomes after reimplantation is crucial for patient management.

Purpose of the Study:

• To investigate the indications for cochlear reimplantation in prelingually deafened children.
• To evaluate the auditory and speech perception outcomes following reimplantation surgery.

Main Methods:

• Retrospective analysis of 45 prelingually deafened children who underwent cochlear reimplantation between 1990 and 2013.
• Recorded causes for reimplantation, device types, insertion angles, and surgical findings.
• Assessed speech perception using phonetically balanced kindergarten words, open-set sentence testing, and speech tracking scores at 1, 2, and 3 years post-reimplantation, comparing them to pre-failure scores.

Main Results:

• Device malfunction (77.7%) was the primary reason for reimplantation, followed by medical reasons (22.2%).
• Postoperative speech perception outcomes showed no significant difference compared to pre-failure scores.
• While 43.2% of children showed over 10% improvement in performance, 16.2% experienced a decline, sometimes linked to partial electrode insertion.

Conclusions:

• Cochlear reimplantation does not adversely affect auditory outcomes in prelingually deafened children.
• Auditory performance generally remains stable or improves after reimplantation.
• A small percentage may experience decreased performance, necessitating tailored rehabilitation strategies.