Related Experiment Video
Updated: Dec 15, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Revision pediatric cochlear implantation in a large tertiary center since 1986
Yann-Fuu Kou1, Jacob B Hunter1, Joe Walter Kutz1
1Department of Otolaryngology - Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Insights
Cochlear implantation (CI) re-implantation is uncommon in children, affecting 4% of patients. While generally safe and preserving hearing outcomes, re-implantation carries a higher risk of future revisions.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Cochlear implantation (CI) is a vital auditory prosthetic for pediatric hearing loss.
- Re-implantation rates and outcomes in pediatric CI recipients are not well-established.
- Understanding re-implantation factors is crucial for optimizing long-term auditory rehabilitation.
Purpose of the Study:
- To determine the incidence of cochlear implantation re-implantation in pediatric patients.
- To evaluate the audiologic outcomes following pediatric CI re-implantation.
- To identify risk factors and indications for re-implantation in children.
Main Methods:
- Retrospective review of medical records for 834 pediatric patients (<18 years) who underwent initial CI.
- Data collected included demographics, audiometric results, radiographic findings, and clinical indications for re-implantation.
- Analysis focused on re-implantation rates, timing, reasons, and subsequent audiologic performance.
Main Results:
- 33 (4%) of 834 pediatric patients required CI re-implantation; 7 (0.8%) needed a second re-implantation.
- The average age at initial CI was 3.5 years, with failure identified 2.7 years later.
- Common indications included unknown etiology (58%), device issues (18%), and trauma (9%).
- Re-implantation maintained open-set speech in 91.7% of those who had it initially and enabled it in 38.1% of those who did not.
- Patients undergoing re-implantation had an increased risk of requiring further revisions.
Conclusions:
- Cochlear implantation re-implantation is infrequent in the pediatric population.
- Re-implantation can be safely performed without compromising audiologic outcomes when indicated.
- Pediatric CI recipients undergoing re-implantation face a higher likelihood of subsequent revision surgeries.
Abstract:
Objective: To identify the rate of cochlear implantation (CI) re-implantation and assess audiologic outcomes. Methods: Demographic, audiometric, radiographic, and clinical data were collected from the medical records of the first 834 pediatric patients (age < 18) who underwent CI at a tertiary-care center. Results: Reviewing the first 834 pediatric patients who underwent CI between 1986 and 2013, 33 (4%) children have required re-implantation. Seven (0.8%) of these required a second re-implantation, for a total of 40 total revision surgeries (4.8%) and 21.1% of patients who underwent revision required multiple re-implantations. The mean age at initial CI was 3.5 years old, with identification of the failure an average of 2.7 years later (range, 0.1-10.1 years). The most common indications for re-implantation CI were unknown etiology (58%), vendor recall (18%), and trauma (9%). Twenty-three (88.5%) of the 26 patients who underwent only one re-implantation surgery achieved a complete insertion with both procedures. Eleven (91.7%) of 12 patients who had open set speech after their initial procedure maintained this after re-implantation surgery. Eight (38.1%) of 21 patients who did not have open-set speech after their initial implantation achieved open set speech with CI re-implantation. Conclusion: CI re-implantation is not common in the pediatric population. However, given the time-sensitive nature of speech/language development in children, with the right indications, CI re-implantation can be performed safely without compromising audiologic outcomes. However, re-implanted patients have an increased risk they will require re-implantation again in the future.
