Cochlear Implantation in Pediatric Patients: Comparison of Limited-Incision and Standard Cochlear Implantation (original) (raw)
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Surgical and medical complications in paediatric cochlear implantation: a review of 300 cases
Cochlear Implants International, 2006
The aim of the study was to investigate an incidence of surgical and medical complications in different age groups of cochlear implant children. A retrospective study design was used. Patients' medical records were reviewed for age at the time of implantation, cause of deafness and complications. The incidence of complications was compared between the young (aged up to 2 years, n = 61) and older children (aged 216 years, n = 239). Some 300 paediatric cochlear implantations were performed in our department between January 1993 and March 2005. Major complications, such as facial nerve paralysis, electrode misplacement, foreign body reaction, fl ap breakdown, protrusion of the positioner and cholesteatoma were rare (3%). Disequilibrium was found to be the most common complication, followed by wound problems and mastoiditis without significant differences between the two groups. However, magnet or receiver-stimulator displacement were more common in the young children (p = 0.028). Most surgical and medical complications could be treated successfully, and only 2% required explantation of the device. Generally, operating on a child aged under 2 years was not particularly different from operating on an older child.
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.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2020
To determine whether variables such as Age, Gender, Demographic background of the patient and Preoperative usage of hearing aids affect the outcomes of pediatric cochlear implant surgery when modified; in terms of speech and hearing gain. A hospital based retrospectiveprospective type of cohort study was conducted over a period of 5 years at a Tertiary care Teaching hospital and referral centre covering a population of about 68.9 million. Candidates selected were 1-5 years of age with bilateral congenital severe-profound sensori-neural hearing loss. 50 patients were selected and were operated using VERIA technique of Cochlear Implant Surgery. Intraoperative testing of electrode functioning was done in all patients using NRT technique. The switching on of implant was done after 1 month, following which patients underwent 100 sessions of auditory verbal therapy and training. Outcomes were evaluated in terms of hearing and speech gain by using Revised CAP scores, ITMAIS scores and PEACH scores in the loco-regional language. Those implanted at a younger age and with at least 3 months of hearing aid usage pre-operatively had better outcomes measures. There was no effect on outcomes when the gender and demographic origin of the patient were compared. Candidates implanted before 3 years age give better results and they should be encouraged to use hearing aid regularly and continuously before the surgery and should be advised trial and fitting as soon as CI planning begins. Also, gender and demographic background should not be considered when planning CI as these have no significant effect on outcomes.
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.
Pediatric cochlear implant revision surgery and reimplantation: An analysis of 957 cases
International Journal of Pediatric Otorhinolaryngology, 2014
Cochlear implantation (CI) is a well-described procedure with a low surgical complication rate [1-4]. Majority of surgical complications as well as device related problems necessitate revision surgery or reimplantation. Although surgical technique basically same, rate and composition of events lead to secondary surgical intervention may differ among children and adults. The aim of this study was to evaluate causes, risk factors, prevention strategies, difficulties encountered during revision cochlear implant surgery and reimplantation in pediatric age group. 2. Methods 2.1. Patients In this study charts of 957 CI patients younger than 18 years of age implanted at our cochlear implant center between 1998 and July 2012 and 18 other referred pediatric CI complications were retrospectively evaluated and reviewed. All our own cases but 9 and all referred cases were unilaterally implanted. Age at implantation, sex, risk factors for complications, type and treatment of complications, time to secondary intervention, problems and important points in revision surgery and reimplantations were analyzed. 2.2. Devices Currently we use devices of all 4 implant manufacturers. However before the end of study only Nucleus 3, Nucleus 4 and
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2021
Cochlear implantation has revolutionized the treatment of sensorineural deafness. The introduction of cochlear implants has made it possible to successfully rehabilitate profoundly deaf adults and children who did not derive any benefit from conventional hearing aids. It is shown that preoperative residual hearing is a positive predictor of good performance with a cochlear implant. 1-3 Candidates with residual hearing are being progressively implanted across the world. Great success has been achieved with hearing preservation technique in conservation of residual hearing after cochlear implantation. This has attributed to improved word understanding, music appreciation and low ABSTRACT Background: Cochlear implantation (CI) has revolutionized the treatment of sensorineural deafness. The aim of the study was to compare auditory based performance in cochlear implants who underwent round window insertion and cochleostomy. Methods: Ambispective cohort study was done among the children who underwent perilingual cochlear implant in a tertiary care hospital for period of 1 year. Children who satisfied the inclusion criteria were selected and randomly subdivided into 2 groups: group Around window insertion and group B-cochleostomy. Pre-and post-operative pure tone average (PTA) and residual hearing preserved were evaluated among the cochleostomy and round window insertion groups separately. Post-operatively, children were evaluated, from three months to 1 year from the activation of cochlear implant, with the use of scores such as Category of Auditory Performance (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility rating (SIR) and Meaningful use of speech scale (MUSS score) to measure speech production skills by auditory verbal therapist. Results: A total of 80 patients were included in the study. Complete hearing preservation (within 10 dB) was significantly high in round window insertion group compared to cochleostomy technique (p<0.001). None the subjects had complete loss of residual hearing. On evaluating the post CI performance, MAIS score in the round window insertion group (9.34, 18.21, 27.79) were significantly better compared to cochleostomy group during the 3 months, 6 months and 12 months follow-up. Conclusions: Round window insertion technique is significantly more successful in complete hearing preservation at low frequencies compared to cochleostomy technique. Among the auditory scores, only MAIS in the round window insertion group was found to be significantly better compared to cochleostomy group.
Cochlear Implant outcomes-A Systematic Review Literature
Background-Paediatric cochlear implant for congenital cases of hearing impairment has no clear view on its outcomes through available scientific literature. The previous research has shown limited evidences on usefulness and effectiveness of Cochlear implant in Paediatric cases. Objective-To systematically review the literature to identify scientific papers which indicate positive outcomes of early Paediatric cochlear implant.This review article highlights the biases inoutcomesof Paediatric cochlear implant surgerydue tosurgical costconcerns, manpower resource training &shortcomings, candidacy age criteria. Method: 2 main literature domains were assessed: CI Surgery,CI Candidacy and search strategies were applied to appropriate databases & journals. Search strategies applied were on appropriate web search database & journals. Inclusion criteria was selected based on keywords finding for articles full text online copy. Result: The review identified 42 citations of which 29 were eligible. Discussion: There are biases seen as a contradiction for the CI procedure for pre-lingual deaf children. The focus & attention of this review addressed clinical effectiveness of early age cochlear implant surgery and rehabilitation of deaf children. Conclusion: This systematic literature review summarizes the comparative importance of implanting deaf children & observing outcomes of cochlear device. Since Cochlear implanted children may show varying improvements & outcomes& therefore those important biaseswere noted closely through this systematic literature review.
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 ...
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2011
The aim of this systematic review of the literature was to summarize the results of scientific publications on the clinical effectiveness of the cochlear implant (CI) procedure in children. The members of the Working Group first examined existing national and international literature and the principal international guidelines on the procedure. They considered as universally-accepted the usefulness/effectiveness of unilateral cochlear implantation in severely-profoundly deaf children. Accordingly, they focused attention on systematic reviews addressing clinical effectiveness and cost/efficacy of the CI procedure, with particular regard to the most controversial issues for which international consensus is lacking. The following aspects were evaluated: post-CI outcomes linked to precocity of CI; bilateral (simultaneous/ sequential) CI vs. unilateral CI and vs. bimodal stimulation; benefits derived from CI in deaf children with associated disabilities. With regard to the outcomes after ...
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.