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Updated: Mar 7, 2026
Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
Consideration for routine outpatient pediatric cochlear implantation: A retrospective chart review of immediate
Sunthosh K Sivam1, Charles A Syms2, Susan M King2
1University of Texas Health Science Center at San Antonio, Department of Otolaryngology-Head and Neck Surgery, San Antonio, TX, USA.
Insights
Pediatric cochlear implantation is safe for outpatient procedures, with a low complication rate of 1%. Nausea and vomiting were the most common issues, manageable in outpatient settings, supporting routine outpatient procedures.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Neurosurgery
Background:
- Cochlear implantation is the primary treatment for prelingual deafness in children.
- The safety of outpatient pediatric cochlear implantation is under debate.
Purpose of the Study:
- To evaluate immediate postoperative complications of pediatric cochlear implantation.
- To inform decisions regarding routine outpatient procedures.
Main Methods:
- Retrospective chart review of pediatric cochlear implantations (ages 1-17) from 2004-2014.
- Analysis of immediate postoperative complication rates and types.
Main Results:
- 1% of 579 cochlear implants (6 cases) required unplanned medical attention.
- Bilateral implantation showed a higher complication risk (OR 1.96) than unilateral.
- Nausea/vomiting and dizziness were the most frequent complications, manageable in outpatient settings.
Conclusions:
- Pediatric cochlear implantation demonstrates a low incidence of complications requiring unplanned medical attention.
- Postoperative nausea and vomiting are common but manageable, supporting outpatient procedures.
- The findings support the routine performance of pediatric cochlear implantation on an outpatient basis.
Introduction:
Cochlear implantation is well accepted as the treatment of choice for prelingual deafness in children [1]. However, the safety of routinely performing this procedure on an outpatient basis is debated. We aim to assess immediate postoperative complications that would affect a surgeon's decision to perform pediatric cochlear implantation on an outpatient basis.
Methods:
A retrospective chart review was conducted which included all children 17 years old or younger who underwent cochlear implantation from 2004 to 2014 in a private neurotology practice. The immediate postoperative complication rates and types of complications were then examined.
Results:
A total of 579 cochlear implants were placed in children ages 1-17 years old from 2004 to 2014. The most common complications were nausea/vomiting and dizziness/imbalance. The odds ratio of developing complications in the group ages 1-3 years old versus all other age patients was found to be statistically insignificant (OR 0.90, 95% CI 0.61 to 1.32, p = 0.58). The odds ratio of developing a complication after bilateral implantation compared to unilateral implantation was statistically significant (OR 1.96, 95% CI 1.18 to 3.28, p = 0.01). There was no difference in complication rates when comparing lateral wall and perimodiolar insertions. A total of 6 of 579 (1%) cochlear implants resulted in a complication requiring unplanned medical attention.
Conclusions:
Overall, this series offers a decade of experience in pediatric cochlear implantation that shows a low incidence of the need for unplanned medical attention in the immediate postoperative period. The most common complication seen is Post-operative nausea and vomiting (PONV) that appears to be amenable to outpatient management even in the youngest populations. This supports providers routinely performing pediatric cochlear implantation on an outpatient basis.
