Surgical and medical complications in paediatric cochlear implantation: a review of 300 cases (original) (raw)
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Clinical results in paediatric cochlear implantation
Cochlear Implants International, 2003
Surgical aspects of paediatric cochlear implantation and peri-and postoperative complications were evaluated in 137 consecutive patients. In 52 children with postmeningitic deafness, 60% of the cochleae showed ossification of some degree at surgery. In eight patients, this led to a partial insertion of the electrode array; in two patients a double array was used. Major intraoperative complications included CSF gusher in three, exposed carotid in one and a dura leak in another child. Major postoperative flap complications were encountered in two children with large skin flaps (1.4%). Three children underwent a reimplantation and one child required revision surgery for cholesteatoma at the implanted ear. The use of a small retroauricular incision has reduced the number of flap-related complications. Overall, the occurrence of major complications was low.
Complications and Their Management Following Pediatric Cochlear Implantations
2012
In the last quarter of the 20th century, cochlear implantation (CI) marked an era in the rehabilitation of profound and severe hearing loss. Along with the advancement in implant technology and surgical experience, as patients benefited from implantation, CI has gradually gained widespread acceptance all around the world. Although the number and severity of complications were reduced with growing surgical experience, rare and new complications were encountered with increasing numbers of implantation. Obviously, elimination of complications has become a major objective for each surgeon. The aim of this study is to present the complications of 344 consecutive pediatric cases of CI. Complications occurring during the follow-up were systematically reviewed and their treatments reported.
Complications in pediatric cochlear implants
American Journal of Otolaryngology, 2010
Objective: The purpose of this study is to retrospectively review the complications of pediatric patients undergoing cochlear implantation at a tertiary referral center. Method: Institutional review board permission was obtained. A retrospective analysis of all pediatric patients (younger than 18 years) who underwent primary cochlear implantation was performed from January 2001 to December 2005. The patients were reviewed for demographic information, type of hearing loss, cochlear implant device, and complications including implant failure, meningitis, hematoma, implant extrusion, cerebrospinal fluid leak, facial palsy, and wound infection. Results: One hundred sixty-five patient records were reviewed. Twenty-nine patients were lost to follow-up or were revision cases; therefore, 136 records were analyzed. Of the patients, 53.5% were male. The most common etiology of hearing loss was nonsyndromic, nongenetic, congenital sensorineural hearing loss (60.6%). Other less common etiology of hearing loss included TORCH (toxoplasmosis, other infections, rubella, cytomegalovirus, herpes simplex virus) (8.3%), connexin mutation (5.8%), and enlarged vestibular aqueduct (6.5%). All patients had a follow-up of 3 years. There were no intraoperative complications. The most common complications were flap infections (2.6%) and immediate postoperative hematomas (1.9%). Flap problems mostly occurred within 2 weeks of implantation. Within the study period, there was only one device failure (0.7%). Conclusions: Cochlear implantation in children continues to be reliable and safe in experienced hands, with a low percentage of severe complications. The patients should have a lifetime follow-up.
Complications of paediatric cochlear implantation: experience in Izmir
Journal of Laryngology and Otology, 2005
Surgery for cochlear implantation (CI) bears the risks of complication associated with all major surgery, in addition to the particular risks associated with implanting a foreign body into the peripheral auditory system. Here we present a retrospective study involving 227 cochlear implant operations in 205 children to evaluate the rate of intra-and post-operative complications. Complications were defined as major complications, requiring explantation of the device or further operation, causing a significant medical problem, or leading to any degree of facial paralysis or requiring additional hospitalization for treatment; or defined as minor complications, namely those that settled spontaneously, with conservative treatment, with local care and/or with medication alone. In our study there were 15 (6.6 per cent) minor and 28 (12.33 per cent) major complications. The most frequent minor complication was dizziness and vomiting (3.08 per cent), followed by transient hemifacial oedema (1.76 per cent), head pain (1.32 per cent) and mild ataxia (0.4 per cent). The most frequent major complication was trauma to the device (9.69 per cent), followed by cerebrospinal fluid (CSF) gusher (2.2 per cent) and facial paresis (0.4 per cent). All of the device trauma cases were re-implanted. There were neither any life-threatening complications nor any facial nerve paralysis in our implanted children. This study confirms that CI is relatively safe and that major complications are few and within acceptable limits.
Cochlear implant surgical issues in the very young child
Cochlear Implants International, 2009
Early cochlear implantation has become more acceptable due to neonatal hearing screening programmes with neurophysiological hearing assessments, allowing early diagnosis in the fi rst few months of life, of profound hearing loss. Cochlear implantation is considered for the child with profound hearing loss, 12 months and younger, in order to enhance early access to hearing and enabling better language outcomes. Surgical issues for the very young child include; reliable pre-operative work up, with objective audiological testing and radiology; limited anatomical access and facial nerve monitoring; bone marrow distribution in the petrous temporal bone in the younger child, and how that resolves in the fi rst 12 months; and the infl uence of acute otitis media and otitis media with effusion on cochlear implantation in children 12 months and younger.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2014
Today, cochlear implantation has become the standard procedure for rehabilitation of people with impaired sensory neural hearing. This procedure can be done through different techniques. The present study aimed to compare the standard technique (ST) with creation of ''C'' incision into the scalp with suture fixation and limited-incision technique (LIT) with creation of subperiosteal pocket without any fixation. The outcomes included operative time and complications. This retrospective study was conducted on 343 consecutive cochlear implantations. The patients received cochlear implants at our institution between 2004 and 2011. The complications were identified as ''minor'' or ''major''. All the complications and operation times were assessed for the two surgical techniques. The overall rates of complications were 4.4 % (11 out of 252) and 2.2 % (2 out of 91) for ST and LIT, respectively. The results revealed no significant difference between the two fixation techniques regarding the complications. The mean operation time was 150 ± 23.7 and 133 ± 23.12 min in ST and LIT, respectively, and the difference was statistically significant. Both ST and LIT are safe techniques with a relatively low complication rate. However, ST can be effectively replaced by LIT because of its shorter operative time.
Complications of Cochlear Implant Surgery: A Public Implant Centre Experience
Pakistan Journal of Medical Sciences, 2021
Objectives: To determine the prevalence of complications of cochlear implant surgery in children with congenital profound sensorineural hearing loss. Methods: This study retrospectively & consecutively reviewed charts of children who underwent cochlear implantation from July 2015 to July 2019 at Cochlear Implant Centre of Otolaryngology Department of Capital Hospital, Islamabad Pakistan. These included cases of both genders aged one to 12 years operated at least one year before the time of data collection. Basic demographic data, complications including major and minor complications and treatment received was noted and statistically analyzed using SPSS-23. Results were presented using descriptive statistics. Results: Current study included a sample of N=251 having a mean age of 4.05±2.15 years including 154(61.4%) males and 97(38.6%) females revealed a prevalence of complications of 16(6.4%) with 4(1.6%) major and 12(4.8%) minor complications. Wound infection and acute otitis media ...
Postoperative complications in cochlear implants: a retrospective analysis of 438 consecutive cases
European Archives of Oto-Rhino-Laryngology, 2012
Our objective is to determine the complication rate in a population of infants, children, adolescents and adults, from a University Hospital Cochlear Implant program and to discuss their causes and treatments. The methods include a retrospective study of 438 consecutive patients in a tertiary referral centre, the Audiology Department of the University Hospital of Ferrara. All patients receiving cochlear implants, between 1 January 2003 and 31 December 2009, have been included. All complications and treatments were systematically reviewed with an average duration of follow-up of 46 months (range 10-84 months). The results reveal that the overall rate of complications in our group was 9.1% (40 of 438), and most of them were minor. Wound swelling and infections represent the most common complication occurred. There were no cases of transient or permanent facial palsy following surgery, and also we did not register any case of postsurgical meningitis. Thirteen patients (3.0%) underwent explantation followed by reimplantation. In conclusion, we find that Cochlear implantation is a safe low-morbility technique with a relatively low complication rate in the presented population.
Cochlear Implant Failure in the Pediatric Population
Journal of Audiology and Otology, 2021
Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation.Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer.Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure...
Perioperative complications of cochlear implant surgery in children
Journal of Anesthesia, 2014
Cochlear implant is a commonly performed surgery for hearing loss in preschool and school children. However, data on anesthesia management and anesthesiarelated complications are sparse. We retrospectively reviewed the data of our institute from January, 2007 to December, 2012. Medical records and anesthesia charts of all the patients who had undergone cochlear implant under general anesthesia between this period were reviewed. Information related to the demographic profile, preoperative evaluation, anesthetic techniques, and perioperative complications were collected and analyzed. A total of 190 patients underwent cochlear implant surgery for pre-lingual (175) and post-lingual (15) deafness. General endotracheal anesthesia with inhalational agents was used in all the cases. Difficult intubation was encountered in three patients. Anesthesia-related complications were laryngospasm at extubation (4.73 %), emergence agitation (2.63 %), and postoperative nausea and vomiting (1.05 %). Major surgical complications were CSF leak without meningitis (3.15 %), device migration/failure (1.05 %), and flap infection (1.57 %). Cochlear implant under general anesthesia in small children is safe and anesthesia-related complications were minimal. Surgical complications, although more frequent, were predominantly minor and self-limiting.