Low surgical complication rates in cochlear implantation for young children less than 1 year of age
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Updated: Oct 23, 2026
Cochlear Implantation in the Guinea Pig
Published on: June 15, 2018
Adedoyin Kalejaiye1,2, Ghedak Ansari3, Gezzer Ortega4,2
1Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Howard University College of Medicine, Washington, DC, U.S.A.
Insights
Cochlear implantation is safe for young children, with similar complication rates across age groups. Infants under one year had higher readmission rates and longer operative times, but overall outcomes were comparable.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Health Services Research
Background:
- Cochlear implantation is a critical intervention for pediatric hearing loss.
- Understanding perioperative risks in pediatric cochlear implantation is essential for optimizing patient care.
- The safety of cochlear implantation in very young children (under 1 year) requires further investigation.
Purpose of the Study:
- To identify risk factors for perioperative morbidity in pediatric patients undergoing cochlear implantation.
- To analyze outcomes based on age, particularly comparing infants under 1 year to older children.
- To evaluate the safety and effectiveness of cochlear implantation in a large national cohort.
Main Methods:
- Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program Pediatric database (2012-2013).
- Identification of 1,351 pediatric cochlear implantation cases using Current Procedural Terminology 69930.
- Analysis of operative characteristics and 30-day perioperative outcomes, including complications, readmissions, and operative times.
Main Results:
- Superficial incisional surgical site infection (SSI) was the most common complication (1.55%).
- Patients under 1 year had higher readmission rates (6.9% vs. 2.7%) and longer operative times (191 vs. 160 minutes).
- Steroid use was identified as a risk factor for unplanned reoperation, SSI, and readmission.
Conclusions:
- Cochlear implantation demonstrates a favorable safety profile in pediatric patients, including those under 1 year of age.
- While infants under 1 year experienced slightly increased readmission rates and operative times, overall morbidity was comparable to older children.
- The findings support current guidelines regarding the age for cochlear implantation, with steroid use being a notable risk factor.
Objective:
To identify risk factors for perioperative morbidity among a large national cohort of pediatric patients undergoing cochlear implantation.
Study Design:
Retrospective study utilizing the American College of Surgeons National Surgical Quality Improvement Program Pediatric database (2012-2013).
Methods:
Pediatric cochlear implantation cases were identified using current procedural terminology 69930. Patients were categorized by age, and operative characteristics along with 30-day perioperative outcomes were analyzed.
Results:
We identified 1,351 cases of pediatric cochlear implantation. The median age was 3.6 years, and 73 patients were less than 1 year of age. Of 21 complication occurrences (1.55%), superficial incisional surgical site infection (SSI) was the most common (n = 13, 61.9%). Thirty-nine patients (2.9%) required readmission. The median operative time was 142 minutes, and the mean postoperative length of stay was 0.58 days. When comparing patients younger than 1 year old to those 1 year or older, no significant differences were noted in complication rate, postoperative length of stay, or reoperation rate. Patients less than 1 year of age were more likely to be readmitted (6.9% vs. 2.7%, P = 0.04) and had longer mean operative times (191 minutes vs. 160 minutes, P = 0.0015). Steroid use was a risk factor for unplanned reoperation, SSI, and readmission.
Conclusion:
Despite a slight increase in readmission rates and operative times among patients less than 1 year of age, cochlear implantation appears to be safe in this population, with complication rates, reoperation rates, and postoperative lengths of stay similar to children undergoing the procedure at the current U.S. Food and Drug Administration-approved age of 1 year and older.
Level Of Evidence:
4. Laryngoscope, 127:720-724, 2017.
