Revision Cochlear Implantation With Device Manufacturer Conversion: Surgical Outcomes and Speech Perception Performance

Yifat Yaar-Soffer ^1,2, Yisgav Shapira ^3,4, Doron Sagiv ⁵

⁰Hearing, Speech, and Language Center, Sheba Medical Center, Ramat Gan, Israel.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery +

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May 8, 2024

View abstract on PubMed

Summary

Revision cochlear implantation (RCI) with device manufacturer conversion (MC) is safe and effective. Despite distinct patient profiles, switching manufacturers during RCI did not negatively impact surgical or speech outcomes, supporting informed patient and CI team decisions.

Area Of Science

Otolaryngology
Biomedical Engineering
Auditory Implants

Background

Revision cochlear implantation (RCI) is sometimes necessary due to device failure or medical complications.
Device manufacturer conversion (MC) during RCI presents unique clinical considerations.
Understanding the profile and outcomes of RCI with MC is crucial for clinical decision-making.

Purpose Of The Study

To describe the clinical profile of RCI cases involving device manufacturer conversion (RCI<sup>mc+</sup>).
To compare RCI<sup>mc+</sup> cases with those without manufacturer conversion (RCI<sup>mc-</sup>).
To classify the reasons for manufacturer conversion in RCI.

Main Methods

Retrospective case review of 185 RCIs performed between 1989 and 2020 at a tertiary academic center.
Data collected included demographics, RCI indications, medical history, surgical details, and reasons for MC.
Post-RCI speech perception was categorized as unchanged, improved, or declined.

Main Results

21% of RCIs involved MC, predominantly in pediatric patients.
Leading indications for RCI<sup>mc+</sup> were device-related (59%) and medical (31%) failures.
RCI<sup>mc+</sup> cases showed higher rates of medical indications, longer intervals to RCI, and more multiple revisions compared to RCI<sup>mc-</sup>.
Speech perception outcomes were similar between RCI<sup>mc+</sup> and RCI<sup>mc-</sup> groups (84% unchanged or improved).

Conclusions

Revision cochlear implantation involving device manufacturer conversion is a safe and beneficial procedure.
Distinct clinical characteristics exist for RCI<sup>mc+</sup> patients, but MC does not adversely affect surgical or speech outcomes.
Findings provide evidence to support informed decision-making for CI teams and patients regarding manufacturer conversion during RCI.

Keywords:

cochlear implant device failure hard failure indications manufacturer revision soft failure speech perception performance surgical outcomes