Reimplante coclear tras disfunción del dispositivo: un estudio de cohorte retrospectivo

To describe the reasons leading to cochlear reimplantation and discuss implications related to technological failures and manufacturer recalls.

Retrospective cohort study over a 40-year period.

Tertiary academic referral center.

Children and adults who underwent cochlear reimplantation between May 1, 1984, and May 1, 2024. Patients were evaluated, treated, and followed at our center.

Cochlear reimplantation.

Incidence of cochlear reimplantation, reasons for explantation, and delay between implantation and reimplantation, stratified by age and device manufacturer.

A total of 3885 cochlear devices were implanted (66% adults). We report 257 reimplantations, including 86 (33%) pediatric cases at a mean age of 9.6 years. Patients were affected by 4 industry-issued recalls. The overall reimplantation rate was 6.6%, with comparable rates in children (6.5%) and adults (6.7%). Manufacturer-specific reimplantation rates were 12.6% for Advanced Bionics, 3.4% for Cochlear, 8.9% for Oticon, and 1.8% for MED-EL. Recalls and hard failures equally accounted for 70.8% of reimplantations. On average, reimplantations occurred 6.5 years after implantation, and 5.8 years in pediatric cases. Reimplantation delays were significantly reduced for recalls compared with hard failures (-3.7 y; P <0.01) and other causes (-4.7 y; P <0.01). About half (50.4%) of reimplantations occurred within 5 years, and 80.2% within 10 years.

This study highlights the complexity of cochlear reimplantation from both technological and human perspectives in a large population. Given the multifaceted burdens of cochlear reimplantation, future efforts should focus on improving device reliability and care pathways to reduce the need for reimplantation.