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Pediatric Cochlear implant soft failure

David Ulanovski1, Joseph Attias2, Meirav Sokolov1

  • 1Pediatric Ear-Nose-Throat Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

American Journal of Otolaryngology
|February 4, 2018
PubMed

Insights

Diagnosing soft cochlear implant failures in children is challenging. A high suspicion is crucial, as delayed diagnosis impacts language development, and integrity tests may be unreliable.

Area of Science:

  • Pediatric Otolaryngology
  • Auditory Implants
  • Medical Device Failure Analysis

Background:

  • Cochlear implant failures are categorized as hard (diagnosed objectively) or soft (suspected clinically).
  • Soft failures present diagnostic challenges, particularly in pediatric populations.

Purpose of the Study:

  • To review the experience with revision cochlear implantation in children, focusing on soft failures.
  • To analyze the diagnostic accuracy and outcomes of revision surgeries for soft cochlear implant failures.

Main Methods:

  • Retrospective review of children (<18 years) undergoing revision cochlear implantation between 2000 and 2012.
  • Collection and analysis of pre- and post-explantation data, including integrity test results and clinical signs.

Main Results:

  • Twenty-six revision surgeries were performed (7.4% of all cochlear implant surgeries).
  • Soft failures accounted for 46% of pre-explantation diagnoses.
  • Integrity tests showed a 63% false-negative rate in the soft failure group; all children regained initial performance post-revision.

Conclusions:

  • Soft cochlear implant failure in children is difficult to diagnose, necessitating a high index of suspicion.
  • Delayed diagnosis of soft failures can negatively impact language development.
  • Normal integrity tests do not rule out device failure; improved diagnostic tools and education are needed.
Abstract

Keywords:
Cochlear implantHard failureSoft failure

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