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Pain After Cochlear Implantation: An Unusual Complication?
Charlotte Celerier1, Isabelle Rouillon, Marion Blanchard
1ENT Department, Necker-Enfants Malades Hospital and Paris-Descartes University, Paris, France.
Summary
Long-term pain after implantation is often underestimated, affecting 1.4% of pediatric patients. Medical treatment is successful in 40%, with surgical intervention needed for persistent cases, highlighting the importance of biofilm evaluation.
Area of Science:
- Pediatric Otolaryngology
- Medical Device Complications
- Pain Management
Background:
- Long-term pain following implantation is an underestimated complication.
- This pain can manifest years after the initial procedure and affect implant usability.
Purpose of the Study:
- To analyze clinical signs of long-term pain after implantation.
- To explore etiological hypotheses for this pain.
- To propose a treatment algorithm and report outcomes.
Main Methods:
- Retrospective review of pediatric patients with device implantation pain (Visual Analog Pain Scale ≥ 4).
- Clinical and electrophysiological assessments were performed.
- Patients were categorized into two groups: pain with swelling (Group PS) and isolated pain (Group P).
Main Results:
- 1.4% of implanted patients (20/1448) experienced long-term pain, with an average onset 5.8 years post-implantation.
- First-line medical treatment achieved success in 40% of cases.
- Surgical intervention, including magnet exchange or reimplantation, was required for 60% of patients, with biofilm detected in 5/7 explanted devices.
Conclusions:
- Pain in the implanted area is a significant complication that can lead to implant non-use.
- The incidence of pain may be underestimated due to underreporting.
- Systematic evaluation for biofilm and device failure is recommended at explantation.
