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Updated: Oct 19, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear Implant Failure in the Pediatric Population
Fulya Ozer1, Haluk Yavuz1, Ismail Yilmaz1
1Department of Otorhinolaryngology, Head and Neck Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Insights
Pediatric cochlear implant (CI) reimplantation rates are low, with trauma being a key factor. Post-revision audiological outcomes in children are generally positive, emphasizing the need for safe environments and family education.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Cochlear implant (CI) revision and reimplantation data can inform surgical protocols for improved outcomes.
- Understanding the causes of CI failure is crucial for pediatric patients.
Purpose of the Study:
- To review the etiology, surgical strategies, and hearing outcomes of CI removal and reimplantation in pediatric patients.
- To analyze the revision rate and causes of reimplantation in children.
Main Methods:
- Retrospective review of 149 cochlear implants in 121 pediatric patients (<18 years).
- Assessment of pre- and postoperative Categories of Auditory Performance (CAP) scores and audiometry thresholds.
- Evaluation of in vivo and ex vivo implant integrity tests.
Main Results:
- The pediatric CI revision rate was 6.7% (10/121 children).
- Head injury causing hard failure was the most common reason for reimplantation (6 cases).
- Other causes included soft failure, electrode migration, and infection; all patients achieved similar or better audiological performance post-reimplantation.
Conclusions:
- Preventing reimplantation due to trauma requires a safe environment and family education, especially for active children.
- Continued postoperative psychiatric consultation may be beneficial for pediatric CI patients.
Background And Objectives:
In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation.
Subjects And Purpose:
All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer.
Results:
A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results.
Conclusions:
It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.
