Surgical and audiologic outcomes following revision cochlear implantation in children

Shelby Barrera; Elizabeth Kerby; Victoria Gonzalez; Jeffrey Carron

doi:10.1016/j.amjoto.2023.104080

Surgical and audiologic outcomes following revision cochlear implantation in children

Am J Otolaryngol. 2024 Jan-Feb;45(1):104080. doi: 10.1016/j.amjoto.2023.104080. Epub 2023 Oct 3.

Authors

Shelby Barrera¹, Elizabeth Kerby², Victoria Gonzalez³, Jeffrey Carron⁴

Affiliations

¹ The University of Mississippi Medical Center, Department of Otolaryngology, Head and Neck Surgery, 2500 North State St., Jackson, MS 39216, United States of America. Electronic address: sbarera@umc.edu.
² The University of Mississippi Medical Center, School of Medicine, 2500 North State St., Jackson, MS 39216, United States of America. Electronic address: ekerby@umc.edu.
³ The University of Mississippi Medical Center, Department of Otolaryngology, Head and Neck Surgery, 2500 North State St., Jackson, MS 39216, United States of America. Electronic address: vgonzalez@umc.edu.
⁴ The University of Mississippi Medical Center, Department of Otolaryngology, Head and Neck Surgery, 2500 North State St., Jackson, MS 39216, United States of America. Electronic address: jcarron@umc.edu.

PMID: 37804793
DOI: 10.1016/j.amjoto.2023.104080

Abstract

Introduction: The incidence of cochlear implantation failure is rare; however, complications can arise in which revision surgery becomes necessary. The purpose of this study is to review our institutional experience with revision cochlear implantation to further understand the surgical and audiological outcomes after cochlear implant failure.

Methods: This is a retrospective review of patients who underwent revision cochlear implantation from 2014 to 2022 at a single institution.

Results: Twenty-one patients required reimplantation within the 8-year study period. During this time frame, a total of 202 cochlear implants were implanted in 171 pediatric patients, resulting in a reimplantation rate of 5.9 %. Our reimplantation patient population were majority white (61.9 %), female (52.4 %), and insured by Medicaid (61.9 %). The average age at implantation was 54.8 months ±47.5 months and the average age at reimplantation was 100.1 months ±55.9 months. The average time between initial implantation and reimplantation was 46.2 months ±30.2 months. The most common sign of failure was abnormal impedances (47.6 %). Reimplantation was required more often for hard failure (76.2 %), which occurred secondary to trauma in 56.3 % of patients, and occurred more frequently in those ages 5-7. Operative findings were unremarkable in 81 % of patients. Those with audiologic data were noted to have stable or improved thresholds after their revision surgery. Three of the 21 patients discontinued use of their processor on the revised ear. Of these, two had known trauma associated with implant failure that was not immediately addressed.

Conclusion: We noted increased rates of hard failure, most commonly secondary to trauma. We noted that majority of those who discontinued use of their implant after revision surgery had associated traumatic injuries that ultimately delayed their presentation and surgery.

Keywords: Audiologic outcomes; Cochlear implant failure; Cochlear implant reimplantation; Hard failure; Soft failure; Surgical outcomes.

MeSH terms

Child
Cochlear Implantation* / adverse effects
Cochlear Implants*
Female
Humans
Prosthesis Failure
Reoperation
Retrospective Studies