Complications of cochlear implant surgery

Acta Otorrinolaringologica (english Edition), 2012

Introduction: Complications are very sensitive indicators of the usefulness of a surgical technique. In cochlear implant surgery, there are 3 principal approaches: the classic approach uses the facial recess (FR), the suprameatal approach (SMA) does not require mastoidectomy and uses the creation of a tunnel over the facial nerve to enter the middle ear, and the endomeatal approach (EMA) is based on the completion of a groove in the posterior wall of external auditory canal. Material and methods: A multicentre review of 208 patients with cochlear implants was performed for comparing the different techniques. The complications were classified into major and minor. Results: Among the 208 implanted patients, 10.5% (22 of 208) had complications. Of these, 2.88% (6 of 208) were major complications and 7.69% (16 of 208) were minor complications. Comparing the results obtained by the different approaches, the FR technique had the lowest rate of major complications (1.1%), followed by the EMA technique with 2.38% and SMA with 3.75%. As for minor complications, operations in the SMA group had the lowest rate (6.25%), followed by the EMA group (7.14%) and the group operated on using the FR technique presented the highest (10%). Conclusions: The 3 techniques described show very similar rates of complications. Consequently, we can conclude that they are safe and are alternatives.

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.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2018

The objective of this study was to achieve uniform reporting of complications and failures in cochlear implantation, to analyze complications and failures and to identify risk factors for complications in a series of over 1300 cochlear implantations. In a retrospective chart review and observational study, data from all cochlear implantations from 1987 to 2015 were entered in a custom-made database. Complications were classified using the contracted form of the Clavien-Dindo system and risk factors were identified by statistical analysis. A complication rate of 18.4% and a device failure rate of 2.9% were found. There was a higher rate of hematoma in patients with a clotting disorder and when a subtotal petrosectomy was performed, a higher rate of wound infections in patients who were not vaccinated against Streptococcus pneumoniae and a higher rate of meningitis in patients with an inner ear malformation. The use of a strict definition of a medical complication and device failure-i...

2012

UNLABELLED Cochlear implantation is a safe and reliable method for auditory restoration in patients with severe to profound hearing loss. OBJECTIVE To describe the surgical complications of cochlear implantation. MATERIALS AND METHODS Information from 591 consecutive multichannel cochlear implant surgeries were retrospectively analyzed. All patients were followed-up for at least one year. Forty-one patients were excluded because of missing data, follow-up loss or middle fossa approach. RESULTS Of 550 cochlear implantation analyzed, 341 were performed in children or adolescents, and 209 in adults. The mean hearing loss time was 6.3 ± 6.7 years for prelingual loss and 12.1 ± 11.6 years for postlingual. Mean follow-up was 3.9 ± 2.8 years. Major complications occurred in 8.9% and minor in 7.8%. Problems during electrode insertion (3.8%) were the most frequent major complication followed by flap dehiscence (1.4%). Temporary facial palsy (2.2%), canal-wall lesion (2.2%) and tympanic membr...

The Journal of Laryngology & Otology, 2008

Objective:To describe problems and complications associated with cochlear implantation, and their management, in a Danish patient population comprising both paediatric and adult patients.Design:Retrospective chart review.Setting:Tertiary referral centre.Subjects:Three hundred and thirteen consecutive cochlear implantations were studied. The median age of the study population was 10 years. Sixty per cent of patients were children and 40 per cent were adult; 52 per cent were female and 48 per cent were male.Intervention:Two hundred and ninety-four patients received a Cochlear Nucleus®implant. The remaining 19 received an Advanced Bionics implant.Main outcome measure:Presence of problems and complications after cochlear implantation.Results:Post-operative complications were found in 15.7 per cent of patients. The majority of these complications (11.2 per cent) were minor; 4.5 per cent were major. The major complications included one patient with meningitis, one patient with multiple an...

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 ...

Annals of Saudi Medicine

BACKGROUND: The number of cochlear implant (CI) recipients is increasing so there needs to be greater awareness of possible CI complications. OBJECTIVES: Describe complications of CI. DESIGN: Retrospective, descriptional. SETTINGS: Tertiary health care center. PATIENTS AND METHODS: Data was collected by retrospective chart review on complications for recipients implanted for the period from January 2006 to June 2017. MAIN OUTCOME MEASURES: Major and minor post cochlear implantation complications. SAMPLE SIZE: 1027 cochlear implant recipients. RESULTS: Post-operative complications were reported in 105 patients (10.2%). Minor complications were most often encountered (9.5%). Swelling (wound seroma or hematoma) was the most common complication. The major complication rate was only 7/105, 0.7%. Meningitis did not occur and cholesteatoma occurred in only one patient. CONCLUSION: CI is a safe surgical procedure at our center. We believe that this is probably due to the preoperative protocol, the surgical technique used, and the postoperative care conducted for all our patients. Despite this, it is important that both physicians and patients have knowledge of the possible consequences and risks posed by CI, especially in view of the fact that these patients require lifetime followup. LIMITATIONS: Further studies are needed, and should include more ENT centers across all regions of Saudi Arabia.

Indian Journal of Otology, 2024

Background: Cochlear implantation is an operation by which the cochlear implant (CI) device is inserted in the cochlea to stimulate electrically the Auditory nerve through its nerve ending in the cochlea. This procedure may be accompanied by some major or minor complications, and as the number of cochlear implantations has increased dramatically during the last decade, it is important to be aware of the potential complications and their management. Objective: The objective is to detect the incidence of early complications of CI in Al‑Yarmouk Teaching Hospital. Patients and Methods: A descriptive study of (173) patients had implantation in the Department of Otolaryngology in Al‑Yarmouk Teaching Hospital/Baghdad through a period of 12 months starting from April 2021 to ending in April 2022. Preoperative assessments were done so that all patients were fit to do the operation; all of these patients have been followed up for 1 month for early detection of complications that classified as major and minor types. Results: There were (96) females and (77) males Patients, the age at implantation for these patients was ranging from 1 to 50 years, the mean age ± standard deviation = (4.95 ± 5.92). The overall rate of complications was 8.7% (15 of 173), with minor complications accounting for 6.9% and including; (unsteadiness 2.9%, facial swelling/forehead skin abrasion 1.1%, wound dehiscence 1.1%, hematoma 0.6%, seroma 0.6%, and simple wound infection 0.6%), these complications were treated conservatively by medical measures or by a minor surgical procedures. Major complications accounting for 1.8% which were; (wound infection that end with flap necrosis 0.6%, biofilm infection 0.6%, and facial nerve palsy 0.6%). Conclusions: CI is a safe technique with a relatively low complication rate. Most of these complications are minor which can be managed with conservative measures or minimal intervention. Skin flap complications range from minor wound infection to wound dehiscence, wound swelling and flap necrosis; this emphasizes the need for careful and delicate manipulation of tissues to avoid such complications. Pay further attention to strict sterilization and strategy regarding disposable towels and surgical kits is needed.

Otology & Neurotology, 2013

Objectives: To review world-wide data on cochlear implant adverse events, test for significant trends over a ten year period, and discuss possible reasons behind such trends. To evaluate the suitability of the Manufacturer and User Facility Device Experience (MAUDE) database for analysis of trends in cochlear implant adverse events.

Cochlear Implants International, 2004

Expanding selection criteria and increasing numbers of cochlear implantations have revealed several challenging cases with regard to surgery and medical point of view. Cochlear implantation of congenitally deaf children with inner-ear malformations may involve difficulties in preoperative evaluation, surgical approach and postoperative follow-up. Cochlear nerve aplasia (as evidence of only one existing nerve in three dimensional magnetic resonance imaging) and hypoplastic cochleas are among the most difficult cases and sometimes children are considered unsuitable for cochlear implantation. However, there is always the possibility that hypoplastic cochleas may include ganglion cells and the only nerve in the internal auditory canal (facial nerve) may contain auditory fibres as well. A positive history of auditory experience and evidence of electrical auditory brainstem response or response to the promontory or round window electrical stimulation may imply that a functioning auditory system is in place. Malformations like common cavity deformity, isolated bilateral vestibular aqueduct enlargement and Mondini dysplasia are usually less challenging, although cerebrospinal fluid leak and postoperative meningitis may be a possibility. In cases of post-meningitic deaf patients, ossification (or obliteration) may be a serious problem even if computed tomography and MRI scan show a patent cochlea or minimal changes. Acoustic neuromas and neurofibromatosis type 2 are other challenging cases, as there is always the possibility that the sensorineural hearing loss is secondary to cochlear damage by interference of the tumour to cochlear blood supply. In conclusion, challenging cases are becoming more common as we are expanding selection criteria, and we should be prepared for alternative cochlear implant devices (straight electrode arrays, dual arrays, compressed arrays, etc.), increased rate of possible complications at, and following, surgery, and functional outcome that may vary considerably among implantees.