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Cochlear implantation in children without preoperative computed tomography diagnostics. Analysis of procedure and
Desiree Ehrmann-Müller1, Wafaa Shehata-Dieler1, Stefan Kaulitz1
1Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany.
Insights
Cochlear implantation in children under 36 months is safe without routine computed tomography (CT) scans. This approach, adopted in 2013, shows no increase in surgical complications or adverse events.
Area of Science:
- Pediatric Otolaryngology
- Medical Imaging in Pediatrics
- Surgical Safety Protocols
Background:
- Growing concerns regarding ionizing radiation risks in children prompted a protocol change in cochlear implantation in 2013.
- The study addresses the safety of omitting preoperative computed tomography (CT) diagnostics for pediatric cochlear implantation.
Purpose of the Study:
- To evaluate the safety and efficacy of cochlear implantation in children under 36 months without routine preoperative CT scans.
- To compare complication rates before and after the implementation of a new protocol in 2013.
Main Methods:
- Retrospective analysis of 89 children under 36 months who underwent cochlear implantation between 2008 and 2018.
- Comparison of operative procedures, postoperative care, and complication rates between two groups: pre-2013 (with CT) and post-2013 (without routine CT).
Main Results:
- Prevalence of preoperative CT scans decreased from 100% before 2013 to 13.3% after the protocol change.
- No significant differences were observed in surgery duration, procedure-related complications, or late complications between the two groups.
Conclusions:
- Cochlear implantation in children under 36 months is a safe procedure even without preoperative CT scans.
- Omitting routine preoperative radiological diagnostics does not introduce additional risks for pediatric cochlear implant patients.
Introduction:
To evaluate the safety in cochlear implantation without preoperative computed tomography diagnostics, which was implemented into the protocol of cochlear implantation in 2013, since in the year before, new evidence concerning the risks of ionizing radiation especially in children arose.
Methods:
In this retrospective data analysis 89 children under 36 months, which were cochlear implanted from 2008 until 2018 at a tertiary referral centre with a large cochlear implant program were analysed. Fortyfour of the children were implanted before the date of change in 2013 and 45 in the following years up to now. The data about the operative procedures, the postoperative care and the complication rate before and after implementation of the new protocol were compared.
Results:
Before the date of change in 2013, 100% of patients received preoperative CT diagnostics, in the following years 13.3%. No difference in the duration of surgery, the procedure related and the late complications between the two groups was identified.
Conclusion:
Cochlear implantation in very young children under the age of 36 months without preoperative radiological diagnostics by CT scan of the temporal bone is a safe procedure without additional risks for the patients.
