Objectives/Hypothesis
The objectives of the study were to present an institutional experience with device failures and cochlear reimplantation rates over a 30‐year period and to perform a detailed literature review.
Study Design
Retrospective institutional experience and literature review.
Methods
A review of cochlear implant failures over a period of 30 years, between January 1988 and March 2017, at a single institution was conducted. Cochlear implant failures were calculated based on manufacturer, type of failure, and overall failure rate. Survival analysis was performed using Kaplan‐Meier curves. An electronic search of the PubMed, Web of Science, and EMBASE databases revealed 24 articles on the topic of cochlear device failure. Data on reimplantation and device failure rates were extracted from this literature review and analyzed.
Results
A total of 804 cochlear implantations were reviewed from three manufacturers. The institutional reimplantation rate was 2.9% compared to the pooled rate of 6.0% calculated from the literature review. Medical failures accounted for 0.5% of the overall failures, device failures accounted for 1.6%, and inconclusive failures account for 0.7%. Survival analysis revealed a significant difference among manufacturers. An improved device failure rate was noted in the adult population (0.8%) as compared to the pediatric population (2.8%).
Conclusions
This 30‐year review represents one of the longest series in the literature examining reimplantation, device failure, and medical failure rates. Cochlear implant survival varied by manufacturer and was significantly better in adult compared to pediatric patients.
Level of Evidence
NA
Laryngoscope, 130:782–789, 2020
Improvements in performance can be attributed to evolving speech coding strategies and speech processors rather than to differences in preimplant candidacy.
Objective:
To present surgical and audiometric outcomes of patients implanted with an active transcutaneous bone conduction implant following the novel middle fossa surgical approach with self-drilling screws.
Study Design:
Retrospective review.
Setting:
Tertiary care center.
Patients:
Thirty-seven adults with either conductive or mixed hearing loss that met indications for an active transcutaneous bone conduction implant were consecutively implanted from April, 2013 to May, 2018.
Intervention:
Unilateral middle fossa implantation of an active transcutaneous bone conduction implant.
Main Outcome Measures:
Patient charts were reviewed for surgical outcomes and complications over the 6-year period. Preoperative air conduction, preoperative bone conduction, and 3-month postoperative aided thresholds were recorded. Speech perception was assessed using CNC words and AzBio sentences. Pure-tone averages (PTAs; measured at 0.5, 1.0, 2.0 and 3.0 kHz), air-bone gap, and functional gain were calculated.
Results:
Mean air conduction and bone conduction PTAs (±standard deviation) of the implanted ear were 66.8 dB (±14.9 dB) and 21.9 dB (±14.0 dB), respectively. Mean aided PTA was 26.5 dB (± 8.5 dB). The average functional gain was 40.3 dB (±19.0 dB). Favorable speech perception outcomes were observed. No complications or instances of revision surgery were reported, with a mean follow-up time of 32 months (range, 9–71 mo).
Conclusions:
This is the first paper to describe outcomes of patients implanted with an active transcutaneous bone conduction implant via the middle fossa with self-drilling screws. Favorable surgical outcomes were observed with a follow-up of up to 6 years.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.