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Updated: Aug 18, 2026
Performing Intracochlear Electrocochleography During Cochlear Implantation
Published on: March 8, 2022
Cochlear implants in children: what constitutes a complication?
1Midwest Ear Institute, Kansas City, MO 64108, USA.
Insights
Surgical complications are rare after cochlear implantation, but device failure and patient management issues are significant challenges. Addressing non-surgical obstacles is key for successful pediatric cochlear implant outcomes.
Area of Science:
- Otolaryngology
- Biomedical Engineering
- Pediatric Medicine
Background:
- Cochlear implantation is a complex procedure with potential surgical and non-surgical complications.
- This study reviews surgical and non-surgical outcomes in 55 pediatric patients who underwent cochlear implantation between 1984 and 1995.
Observation:
- While surgical complications like skin flap issues, infection, and facial paralysis were infrequent, ossification of the cochlea was a common surgical obstacle (40%).
- Computed tomographic scanning failed to detect ossification in 16.3% of cases.
- Non-surgical problems, including device failure (10.9% in multichannel implants), temper tantrums, parental interference, and socioeconomic factors, presented significant management challenges.
Findings:
- No surgical complications were reported in the 55 pediatric patients.
- Ossification, particularly at the round window and scala tympani, was the most frequent surgical challenge.
- Device failure was the most critical non-surgical complication, impacting patient management and rehabilitation.
Implications:
- Effective management of non-surgical factors, such as device reliability and family compliance, is crucial for optimizing pediatric cochlear implant success.
- Further research into improving ossification detection and prevention strategies is warranted.
- A multidisciplinary team approach is essential to address the complex needs of children with cochlear implants.
Abstract:
The surgeon must ultimately accept the responsibility for any complications that occur as the result of a cochlear implant. Listening to the cochlear implant team members and responding to their needs may enhance the child's progress. Surgical complications, (i.e., skinflap problems, infection, and facial paralysis) are indeed infrequent, but nonsurgical problems are not. Surgical and nonsurgical experiences were reviewed in 55 children. Ages ranged from 23 months to 18 years at the time of cochlear implantation, which occurred from 1984 to 1995. There were no surgical complications. However, the most common surgical obstacle was ossification, which was present in 40% and undetected by computed tomographic scanning in 16.3% of children. Ossification occurred at the round window and scala tympani in 32.7% and involved the cochlea more extensively in 7.3% of children. In only one child was the cochlea entirely ossified. There were, however, many nonsurgical problems that were viewed as complications in patient management. The single most important complication was device failure. This occurred in 10.9% (5/46) of children with the Cochlear Corporation multichannel implant. Head banging and other temper tantrums, parental interference with rehabilitation, socioeconomic factors, poor compliance by the family unit, equipment problems, educational deficiencies, and impatience with habilitative training were some of the other problems.
