The experience of device failure after cochlear implantation

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Audiology

Background:

• Cochlear Implantation (CI) is a vital treatment for severe to profound hearing loss.
• Device failure can significantly impact patient outcomes and quality of life.
• Identifying early signs of CI device failure is crucial for timely intervention.

Purpose of the Study:

• To describe the management of cochlear implant device failures at a tertiary center.
• To identify prodromal symptoms indicative of cochlear implant device failure.
• To analyze audiological outcomes following revision surgeries for device failure.

Main Methods:

• Retrospective review of 1431 cochlear implant surgeries performed between January 2000 and May 2017.
• Analysis of factors including etiology of hearing loss, age at surgery, device type, and symptoms of device failure.
• Evaluation of audiological outcomes using Categories of Auditory Performance (CAP) scores.

Main Results:

• A total of 27 (1.9%) patients experienced device failure requiring revision surgery.
• The most common etiologies were idiopathic hearing loss and cochlear hypoplasia.
• Intermittent loss of signal was the most suggestive symptom of device failure. Advanced Bionics devices showed a higher failure rate (10.0%) compared to Cochlear (1.3%) and MED-EL (3.1%).
• Mean CAP scores improved post-revision surgery, indicating continuous development of auditory performance.

Conclusions:

• Intermittent loss of signal strongly suggests cochlear implant device failure and warrants electrical examination.
• Revision surgeries for device failure can lead to sustained improvement in audiological outcomes.
• Understanding device failure rates across manufacturers is important for patient counseling and device selection.