Cochlear re-implant rates in children: 20 years experience in a quaternary paediatric cochlear implant centre

Abstract

The aim of this study is to determine the incidence and causes for cochlear explantation/re-implantation in children as a retrospective case review in a Quaternary paediatric Cochlear Implant (CI) Centre. The subjects included in the study were Paediatric CI patients requiring cochlear explantation/re-implantation. Outcome measurements were incidence and aetiology of device explantation/re-implantation. Patient age at implantation, aetiology of deafness, CI manufacturer, and timing of explantation/re P implantation were the independent variables. 778 paediatric cochlear implants were performed in 653 children between 1992 and January 2013. There were a total of 40 (5.1%) failed implants in 38 patients. The most common reason for explantation was device failure in 22 (2.8%). Risk factors for device failure were known manufacturing defect/device recall. Medical/surgical issues accounted for 18 (2.3%) implant failures. The mean time to explantation was 3 years 10 months. The incidence of explantation/re-implantation in our paediatric cochlear implant population is comparable to other published studies. The most common reason for explantation was device failure, however, the aetiology of deafness, in particular meningitis, does not appear to increase the risk of explantation as described in previous series.

Cochlear Implant Reliability: On the Reporting of Rates of Revision Surgery

“…Long study periods are by default more recent publications. It is evident that higher numbers of both children and children receiving bilateral implants occur in the later study period [20][21][22] (only unilateral implants were provided up to the early 2000s). With this 'implants -v-time' profile the results of such studies will be biased by the large number of newer implants with a short duration of use even when total study length is 20 years or more.…”

Clinical profile and management of revision cochlear implant surgeries

“…In the literature, the rate of implants required revision surgery was reported to be between 3.6% and 11%. [4][5][6][7][8] In the current study, 4% of total Revised cochlear implant surgeries ... Aldhafeeri et al Table 1 -Summary of revision cases based on implant companies. cochlear implanted patients underwent revision surgery.…”

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

“…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.…”

“…Previous authors acknowledge technological upgrade as a possible reason for CIR but do not report on any cases in this category . Overall reported incidence rates for CIR fall between 3% and 13%, with slightly higher rates among children than adults (5%–13%) . 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) .…”