Medical and surgical complications of the second 100 adult cochlear implant patients in Birmingham

Dutt, Sunil; Ray, Jaydip; Hadjihannas, Edward; Cooper, Huw; Donaldson, Ivor; Proops, David W.

doi:10.1258/002221505774481291

Cited by 54 publications

(45 citation statements)

References 3 publications

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“…Nevertheless, the surgical procedure may be expected to have a risk of deafness similar to stapedectomy [Shea, 1998;Häusler, 2000] or cochlear implantation [Green et al, 2004;Dutt et al, 2005]. In our patients, hearing thresholds were in an order of magnitude that approached those of cochlear implant candidates.…”

Section: Discussionmentioning

confidence: 68%

A Novel Implantable Hearing System with Direct Acoustic Cochlear Stimulation

et al. 2008

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A new implantable hearing system, the direct acoustic cochlear stimulator (DACS) is presented. This system is based on the principle of a power-driven stapes prosthesis and intended for the treatment of severe mixed hearing loss due to advanced otosclerosis. It consists of an implantable electromagnetic transducer, which transfers acoustic energy directly to the inner ear, and an audio processor worn externally behind the implanted ear. The device is implanted using a specially developed retromeatal microsurgical approach. After removal of the stapes, a conventional stapes prosthesis is attached to the transducer and placed in the oval window to allow direct acoustical coupling to the perilymph of the inner ear. In order to restore the natural sound transmission of the ossicular chain, a second stapes prosthesis is placed in parallel to the first one into the oval window and attached to the patient’s own incus, as in a conventional stapedectomy. Four patients were implanted with an investigational DACS device. The hearing threshold of the implanted ears before implantation ranged from 78 to 101 dB (air conduction, pure tone average, 0.5–4 kHz) with air-bone gaps of 33–44 dB in the same frequency range. Postoperatively, substantial improvements in sound field thresholds, speech intelligibility as well as in the subjective assessment of everyday situations were found in all patients. Two years after the implantations, monosyllabic word recognition scores in quiet at 75 dB improved by 45–100 percent points when using the DACS. Furthermore, hearing thresholds were already improved by the second stapes prosthesis alone by 14–28 dB (pure tone average 0.5–4 kHz, DACS switched off). No device-related serious medical complications occurred and all patients have continued to use their device on a daily basis for over 2 years.

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Section: Discussionmentioning

confidence: 68%

A Novel Implantable Hearing System with Direct Acoustic Cochlear Stimulation

et al. 2008

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“…Consistent with otosclerosis as a recognized cause of vestibular complaints, four patients experienced vertigo prior to the surgery [14,15] . However, two patients had postoperative vertigo, which was clearly related to the surgery, one of which was due an unintentional lesion of the vestibule during the operation.…”

Section: Discussionmentioning

confidence: 90%

“…Vertigo is a common complication of CI [7,11,14] . Consistent with otosclerosis as a recognized cause of vestibular complaints, four patients experienced vertigo prior to the surgery [14,15] .…”

Section: Discussionmentioning

confidence: 99%

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

West¹,

Brand²,

Foghsgaard³

et al. 2017

Int Adv Otol

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OBJECTIVE:To report surgical results and complications of cochlear implantation in patients with far-advanced otosclerosis (FAO). MATERIALS and METHODS:This was a retrospective chart review of surgical results in terms of electrode insertion as well as peri-and postoperative complications. Ten cochlear implantations (CIs) were performed in eight patients with FAO. A prior stapedotomy had been performed in all cases. RESULTS:Full electrode insertion was achieved in nine of the 10 operations (90%) and partial insertion in one operation. An unintended opening of the vestibule during drilling was the only perioperative complication. Postoperative complications occurred as two cases of vertigo (one prolonged). No chorda tympani syndrome and no cases of facial nerve stimulation were noted. CONCLUSION:Although based on a limited number of cases, we conclude that full electrode insertion can be achieved in almost all cases and that major complications are infrequent in CI in patients with FAO. Postoperative vertigo appears to be the most commonly occurring complication.

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“…Excluding device-related complications and facial palsy, migration-extrusion of the implant body and flapwound problems are the major complications of cochlear implant surgery. In their cochlear implantation series, Dutt et al [18] reported complications of flap breakdown (1.6%), extrusion of electrode array (0.8%) and device failure (0.8%). Migirov et al [19] found that the main reason for revision surgery was device failure followed by woundflap complications for cochlear implant surgery.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Cochlear Implantation with Mastoidal Three-Layer Flap Technique

Ulug

Teker²

2009

ORL

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Aims: To describe and evaluate a minimally invasive cochlear implantation approach using mastoidal three-layer flap (TLF) technique. Methods: We conducted a prospective clinical study at a tertiary referral center. The study population comprised 32 males and 16 females, with an age range of 1–51 years. Thirty-nine patients were operated on using the TLF technique and 9 patients were operated on using a classical cochlear implantation technique. The TLF technique was based on using the superficial musculoaponeurotic system (SMAS) as an additional, strong flap layer. The TLF, with 3 different pedicules, comprised an anteriorly based 4-cm skin flap, a superiorly based temporomastoidal flap, which included the SMAS, and an anteriorly based periostal Palva type flap in the same mastoidal area. Results: No major complications, including flap-wound problems and receiver-stimulator migration or extrusion, were encountered. The mean operation time was 66 min in the TLF population and 92 min in the classical operation population, which shows a statistically significant difference noted in the time of operation (p = 0.0001). Conclusion: The TLF cochlear implantation enables complete receiver-stimulator coverage and safe fixation without any additional procedures, while allowing reduced operation time.

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Medical and surgical complications of the second 100 adult cochlear implant patients in Birmingham

Cited by 54 publications

References 3 publications

A Novel Implantable Hearing System with Direct Acoustic Cochlear Stimulation

A Novel Implantable Hearing System with Direct Acoustic Cochlear Stimulation

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

Minimally Invasive Cochlear Implantation with Mastoidal Three-Layer Flap Technique

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