Day-case otology: Special attention to the pediatric cochlear implantation procedure

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Anesthesiology

Background:

• Cochlear implantation is a critical intervention for pediatric hearing loss.
• Day-surgery offers potential benefits in terms of cost-effectiveness and patient experience.
• Assessing the feasibility of day-surgery for pediatric cochlear implantation is essential for optimizing care pathways.

Purpose of the Study:

• To evaluate the feasibility of cochlear implantation as a day-surgery procedure in children.
• To identify factors influencing admission, readmission, and unplanned postoperative consultations.
• To determine the safety and efficacy of same-day discharge after pediatric cochlear implantation.

Main Methods:

• Retrospective observational monocentric study adhering to STROBE recommendations.
• Analysis of medical records of 66 children undergoing cochlear implantation between January 2017 and July 2022.
• Inclusion criteria focused on first-time admission to pediatric day-surgery; exclusion criteria included planned inpatient procedures, bilateralization, or explantation-reimplantation.

Main Results:

• Successful day-surgery management was achieved in 86% of pediatric cochlear implantation cases.
• Reasons for admission to the pediatric ENT unit included late awakening (6%), uncontrolled pain (4.5%), and postoperative nausea/vomiting (3.5%).
• No significant factors influenced day-surgery success based on anesthetic agents, age, or operating room time; no readmissions occurred, and unplanned consultations were minimal (3%).

Conclusions:

• Pediatric cochlear implantation can be safely and effectively performed as a day-surgery procedure.
• The findings support the suitability of same-day discharge for cochlear implantation in children across all age groups.
• Day-surgery management for pediatric cochlear implantation enhances surgical accessibility without compromising patient safety or outcomes.