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Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Cochlear implant revision surgeries in children
Maria Stella Arantes do Amaral1, Ana Cláudia Mirândola B Reis2, Eduardo T Massuda2
1Universidade de São Paulo (USP), Pós Graduação, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil.
Insights
Cochlear implant revision surgery, necessary in 4.23% of cases, effectively improves hearing and language outcomes in pediatric patients. These procedures address complications like device failure and calcification, validating their use.
Area of Science:
- Otorhinolaryngology
- Pediatric Surgery
- Biomedical Engineering
Background:
- Cochlear implantation surgery carries inherent risks, potentially necessitating revision surgeries for internal device issues.
- Understanding the indications and outcomes of revision surgery is crucial for optimizing pediatric hearing restoration.
Purpose of the Study:
- To determine the indications for cochlear implant revision surgery in pediatric patients.
- To evaluate the effectiveness of revision surgeries on hearing and language development.
- To identify factors correlated with the need for revision surgery.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) undergoing cochlear implantation between 2004-2015.
- Data collection included patient demographics, hearing loss etiology, audiological/language assessments, and surgical revision details.
- Analysis of 265 surgeries in 236 patients, focusing on 10 patients requiring revision.
Main Results:
- The incidence of cochlear implant revision surgery was 4.23% (10 out of 236 patients).
- Common reasons for revision included cochlear calcification (post-meningitis/trauma), device failure, and electrode issues.
- Two patients required cochlear implant removal due to malformation or trauma.
Conclusions:
- Cochlear implant revision surgery is a valid intervention, with a low incidence rate.
- Post-revision, patients demonstrated improved hearing and language performance.
- Revision surgeries are effective in addressing complications and restoring auditory function.
Introduction:
The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries.
Objective:
To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing.
Methods:
A retrospective study of patients under 18 years submitted to cochlear implant surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after cochlear implant surgery and any need for surgical revision and the reason for it.
Results:
Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted.
Conclusion:
The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases.
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