Cochlear implant failures and reimplantation: A 30‐year analysis and literature review

Lane, Ciaran; Zimmerman, Kim; Agrawal, Sumit; Parnes, Lorne S.

doi:10.1002/lary.28071

Cited by 47 publications

(57 citation statements)

References 31 publications

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“…With a follow-up period of eight years, our revision rate of children was 6.7%. This is similar with the revision rate of other studies in literature [1,10,23]. Brown, et al [24] found that the revision rate was higher in pediatric population with 7.3% than adult with 3.8% and also showed that the hard failure was more seen reason with the rate of 55% in their study.…”

Section: Discussionsupporting

confidence: 88%

Cochlear Implant Failure in the Pediatric Population

et al. 2021

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Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation.Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer.Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results.Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.

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Section: Discussionsupporting

confidence: 88%

Cochlear Implant Failure in the Pediatric Population

et al. 2021

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“…They found that at 10 years post-implantation, almost 30% of children with unilateral implants are expected to undergo RCI. Although this finding considerably exceeded other reported revision rates [ 4 , 34 ], it illustrated the importance of interpreting results with respect to a relevant timeframe. According to our data, the mean time interval between Pri-CI and RCI was 6.6 years, comparable to results of other studies, which reported a mean length of device use before revision of 4.7–6 years [ 4 , 16 , 17 , 35 ].…”

Section: Discussioncontrasting

confidence: 68%

“…In other words, 70% of RCIs were performed in cases having an implant lifetime of less than 10 years. Further analysis, focusing on the time between Pri-CI and the onset of symptoms that led to RCI, revealed a significant prolongation in children compared to adults, presumably related to the unique challenges involved in diagnosing CI failures in the pediatric population [ 34 , 36 ]. Taken together, our results strongly emphasize the need for close monitoring and special attention regarding follow-up of babies and young children, especially during their first years of implant use.…”

Section: Discussionmentioning

confidence: 99%

Rates, Indications, and Speech Perception Outcomes of Revision Cochlear Implantations

Sagiv

Yaar-Soffer

Yakir

et al. 2021

JCM

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Revision cochlear implant (RCI) is a growing burden on cochlear implant programs. While reports on RCI rate are frequent, outcome measures are limited. The objectives of the current study were to: (1) evaluate RCI rate, (2) classify indications, (3) delineate the pre-RCI clinical course, and (4) measure surgical and speech perception outcomes, in a large cohort of patients implanted in a tertiary referral center between 1989–2018. Retrospective data review was performed and included patient demographics, medical records, and audiologic outcomes. Results indicated that RCI rate was 11.7% (172/1465), with a trend of increased RCI load over the years. The main indications for RCI were device-related failures (soft-45.4%, hard-23.8%), medical failure (14%), trauma (8.1%), and surgical failure (6.4%). Success rate was 98.8%. Children comprised 78% (134) of the cohort and were more likely than adults to undergo RCI. Most (70%) of the RCIs were performed within 10 years from primary implantation. Speech perception outcome analysis revealed unchanged or improved performance in 85% of the cases and declined performance in 15%. Current findings confirm that RCI is a safe with high clinical efficacy; however, the non-negligible percentage of patients that exhibited declined performance post-RCI should be considered in decision-making processes regarding RCI. Routine follow-up during their first years post-implantation is warranted.

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“…Using minimally invasive surgical techniques and less traumatic devices for inner ear, we can avoid the cochlear and vestibular lesions not only for the first cochlear implantation intervention, but also for the reimplantation purposes, even these cases are not very frequent, as many studies have shown, the CI devices having a very good reliability [36][37][38].…”

Section: Figure 4 -Postoperative Saccular Status (T1) For Bilateral Sequential Versus Bilateral Simultaneous Cochlear Implantation In Chimentioning

confidence: 99%

Saccular function evolution related to cochlear implantation in hearing impaired children

Cozma

Cristina

Cobzeanu³

et al. 2020

Rom J Morphol Embryol

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Vestibular sensorial input is essential for psychomotor development of the very small children. In consequence, possible vestibular impairment induced by cochlear implantation in deaf children could affect the balance and walking learning process. Some of cochlear implanted children can present congenital vestibular deficit. The anatomical and embryological relation between auditory and vestibular system explains why congenital neurosensorial hearing loss may associate vestibular impairment. The cochlear implant surgery presents a vestibular lesion risk. Bilateral vestibulopathy, as it appears in early childhood, has a poor prognosis for the psychomotor and cognitive development. Even probably rare, bilateral vestibulopathy induced by simultaneous bilateral cochlear implantation can delay the acquisition of motor skills. This pathology can be avoided by an appropriate surgical indication related to the vestibular preoperative status. This study reports the vestibular saccular functional modifications after the cochlear implantation in children. The cervical vestibular evoked myogenic potentials (cVEMPs) were performed in children before and after the cochlear implantation. Since previous studies report different vestibular impairment related to the portelectrode insertion approach, another objective of our study was to assess the saccular postoperative status depending of the insertion by cochleostomy (CO) or through the round window (RW). We performed cVEMPs for 80 patients (135 cochlear implanted ears) before and after cochlear implantation. We have detected preoperative saccular areflexia in 33 (24.4%) ears. In the group of 102 (75.6%) ears with preoperative normal saccular function, 72 (70.6%) ears preserved the cVEMP response after the surgery, while in 30 (29.4%) ears the cVEMP response was lost. Reporting our findings to the portelectrode insertion method, we found normal saccular function in 73.3% of the cochlear implanted ears by RW surgical approach and in 68.42% ears by CO approach. These results suggest that the RW portelectrode insertion is the recommended strategy in order to avoid the saccular vestibular impairment.

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Cochlear implant failures and reimplantation: A 30‐year analysis and literature review

Cited by 47 publications

References 31 publications

Cochlear Implant Failure in the Pediatric Population

Cochlear Implant Failure in the Pediatric Population

Rates, Indications, and Speech Perception Outcomes of Revision Cochlear Implantations

Saccular function evolution related to cochlear implantation in hearing impaired children

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