Rates of Delayed Postcochlear Implant Pain in the Pediatric Population-Role of Proactive Approach
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Insights
Delayed postoperative cochlear implantation pain (DPCIP) affects up to 12% of pediatric patients, often with new onset years after surgery. This highlights the need for proactive pain management and informed consent discussions.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Pain Management
Background:
- Delayed postoperative cochlear implantation pain (DPCIP) is a significant concern in pediatric patients.
- Understanding the incidence and characteristics of DPCIP is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the rates of DPCIP in pediatric patients using a proactive approach.
- To explore the influence of surgery extent and patient ethnicity on DPCIP.
Main Methods:
- A cross-sectional study involving telephone questionnaires for parents of children who underwent cochlear implantation (CI) between 2007 and 2020.
- Pain assessment at four time points: post-surgery hospitalization, 3 months, 2 years, and 5 years.
- Data collected from medical records for demographics, surgery details, and complications.
Main Results:
- Out of 129 pediatric patients included, 8.5% reported pain at 3 months and 2 years post-surgery.
- Pain incidence increased to 12% at 5 years, with a significant proportion experiencing new onset pain.
- Neither surgery extent nor cultural background were associated with DPCIP rates, nor were surgical complications.
Conclusions:
- Delayed postoperative cochlear implantation pain (DPCIP) may be underrecognized, with rates up to 12%.
- The long-term nature of DPCIP, including new onset pain, warrants acknowledgment and discussion during the informed consent process.
- Proactive assessment and management strategies are essential for pediatric CI patients experiencing long-term pain.
Objective:
To investigate the rates of delayed postoperative cochlear implantation pain (DPCIP) in the pediatric population, using a "reach-out" proactive approach. Secondary aims included the possible impact of surgery extent or the patient ethnicity on DPCIP rates.
Materials And Methods:
A cross-sectional study was conducted at Soroka University Medical Center in Israel. Demographics and data regarding the surgery and surgical complications were collected from the medical records of the patients. A telephone questionnaire was conducted for parents of all children who underwent cochlear implantation (CI) between 2007 and 2020. The questions addressed pain at four time periods: during hospitalization after surgery, 3 months, 2 years, and 5 years after surgery.
Results:
Out of 213 patients, 129 (60%) were included in this study. The mean age was 41 months (±40). Unilateral CI was performed in 72 (56%) patients. At 3 months and 2 years after surgery, 8.5% of patients reported pain (visual analog scale [VAS] ≥ 1). Five years after surgery, a slight increase in the number of patients who reported pain (12%) was observed. Of those experiencing pain 2 years and 5 years after surgery, 10/12 (83%) and 11/16 (69%), respectively, reported a new onset of the pain. Surgery extent and cultural background were not significantly associated with DPCIP rates. No correlations were found between patients complaining of pain and any surgical complications.
Conclusions:
DPCIP rates may be underrecognized and higher than previously reported, reaching up to 12%. This long-term effect should be acknowledged and discussed with parents upon informed consent.
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