Cochlear Implant Failure and Revision Surgery in Pediatric Population

Blanchard, M.; Thierry, Briac; Glynn, Fergal; Lamaze, A. De; Garabédian, E. N.; Loundon, Natalie

doi:10.1177/0003489414551931

Cited by 39 publications

(30 citation statements)

References 17 publications

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“…2,4 Overall reported incidence rates for CIR fall between 3% and 13%, with slightly higher rates among children than adults (5%-13%). [2][3][4][5]7,[13][14][15] CIR may be motivated by a number of factors, including hard device failure (patient performance declines secondary to malfunction of the internal device), soft failure (patient performance declines in the absence of identifiable device malfunction), trauma (e.g., blow to the head), or medical complications (e.g., infection, migration of the internal device). 1-3,7,13 From a group of 60 patients undergoing CIR, Donatelli Lassig et al 1 describe 10 patients who reported technology upgrade as a primary reason for undergoing revision surgery.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 The stability of speech recognition abilities is of particular interest because some patients may continue to demonstrate excellent scores even when CIR is indicated (e.g., in cases of medical complications). The rate of declined performance is typically less than 15% of reimplanted patients, 1,4,5 with some groups reporting stable or improved audiometric performance in 100% of their CIR patients. 6,7 It is important to note that patients will require variable time to adapt to their new device and achieve these stable or improved scores.…”

Section: Introductionmentioning

confidence: 99%

“…8 Although previous authors acknowledge technological upgrade as a possible reason for CIR, they do not report on any cases in this category. 2,4 The aim of this study was to evaluate outcomes of individuals initially implanted with an Advanced Bionics (AB) Clarion C1.2 internal device (Advanced Bionics, LLC, Valencia, CA) who underwent CIR with AB HiRes90K Advantage HiFocus Mid Scala or AB HiRes Ultra HiFocus Mid Scala internal device as a means of technology upgrade.…”

Section: Introductionmentioning

confidence: 99%

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When to replace legacy cochlear implants for technological upgrades: Indications and outcomes

et al. 2018

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Objective To determine indications, surgical efficacy, and audiologic outcomes of replacing Advanced Bionics Clarion C1.2 internal devices (Advanced Bionics, LLC, Valencia, CA) as a means of technology upgrade. Study Design Retrospective review, case series. Methods Ten patients were initially implanted as a child (mean age = 3.87 years) and underwent cochlear implant reimplantation (CIR) with current Advanced Bionics internal device as a young adult (mean duration of implant use = 15.66 years). Demographic data and pre‐ and post‐CIR speech perception scores were collected. Results Technology upgrade was the primary (9) or secondary (1) motivation for CIR. No surgical complications were noted, and full insertion was obtained in nine cases. Intraoperative impedance levels and neural response imaging measures were within normal limits for eight patients. At most recent post‐CIR follow‐up evaluation, all patients (100%) performed within or better than the 95% confidence interval of their pre‐CIR word and sentence recognition scores; and 55.6%, 50.0%, and 50.0% of patients performed above the 95% confidence interval of their pre‐CIR scores for the CNC words, sentences in quiet, and sentences in noise, respectively. Conclusion Post‐CIR audiological benefit was stable or improved compared to pre‐CIR results in all categories by 3 months after reactivation. Given these results, patients who are unable to use the most current external processors due to incompatibility with a legacy internal device could consider reimplanation to optimize their overall performance with a cochlear implant. Level of Evidence 4 Laryngoscope, 129:748–753, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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When to replace legacy cochlear implants for technological upgrades: Indications and outcomes

et al. 2018

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“…While recent studies suggest that 94% of revision surgeries result in full reinsertion of the electrode, this success rate decreases when there are postsurgical changes in the cochlea after primary implantation 16. Patients with a previous history of meningitis are particularly at risk for complications associated with electrode array implantation and removal.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with a previous history of meningitis are particularly at risk for complications associated with electrode array implantation and removal. The partial ossification of the cochlea that occurs with meningitis can make it difficult to achieve full implantation of the electrode and may result in partial implantation16 or require implantation with a short electrode, specifically designed for cases in which major ossification of the cochlea has occured 21. Ossifications can complication revision surgery, even with a slight enlargement of the cochleostomy and result in partial reimplantation 16.…”

Section: Discussionmentioning

confidence: 99%

Medical and bioethical considerations in elective cochlear implant array removal

et al. 2017

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Revision Cochlear Implantation With Device Manufacturer Conversion: Surgical Outcomes and Speech Perception Performance

Yaar‐Soffer,

Shapira,

Sagiv

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveDescribe the clinical profile of revision cochlear implantation (RCI) cases involving device manufacturer conversion (RCImc+), compare them to cases without manufacturer conversion (RCImc−), and classify the reasons for manufacturer conversion (MC).Study DesignRetrospective case review.SettingTertiary academic center.MethodsData on demographics, RCI indications, medical background, surgical details, and the reasons for MC were collected for all RCIs from 1989 to 2020. Post‐RCI speech perception performance was categorized as unchanged, improved, or declined, according to clinically based criteria.ResultsOf 185 RCIs, 39 (21%) involved MC, mostly in pediatric patients (67%). The leading RCImc+ indications were device‐related (59%) and medical (31%) failures. Initial implant manufacturers were Advanced Bionics (49%), Cochlear (25.5%), or Medel (25.5%). Most MC reasons were patient‐driven (64%) versus CI team recommendations (36%). The RCImc+ group demonstrated a 3‐fold higher rate of medical indications than RCImc− (31% vs 11.5%, P = .007). The time interval from symptom onset to RCI was longer in RCImc+ (43 vs 20.3 months, P = .001), and the rate of multiple revisions in the same ear was higher (25.6% vs 8.2%, P = .009). Complete reinsertion rates were high in both RCImc+ and RCImc− (94.8% vs 94.5%, P = 1) without any complications. Speech perception improved or remained unchanged in most (84%) cases, with no significant difference between the groups (P = .183).ConclusionThis retrospective study showed that RCI involving MC is safe and beneficial. Although RCImc+ patients exhibited distinct clinical characteristics, MC did not impact surgical or speech perception outcomes. This provides evidence‐based data to support informed decision‐making by CI teams and patients.

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Cochlear Implant Failure and Revision Surgery in Pediatric Population

Cited by 39 publications

References 17 publications

When to replace legacy cochlear implants for technological upgrades: Indications and outcomes

When to replace legacy cochlear implants for technological upgrades: Indications and outcomes

Medical and bioethical considerations in elective cochlear implant array removal

Revision Cochlear Implantation With Device Manufacturer Conversion: Surgical Outcomes and Speech Perception Performance

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