Medical or Surgical Complications Related to the Nucleus Multichannel Cochlear Implant

Abstract

A questionnaire was sent to 152 surgeons to survey complications associated with the implantation of the Nucleus multichannel cochlear implant. Complications were categorized as life-threatening; major, if they necessitated revision surgery; or minor, if they resolved spontaneously or with minimal treatment. A total of 55 complications occurred in 459 reported operations for an overall complication rate of 11.8%. There were no deaths, but there was one life-threatening complication, a case of meningitis. There were 23 (4.8%) major complications, most of which involved flap design or electrode insertion (and included the case of meningitis). There were 32 (7 %) minor complications. Most of the complications might have been avoided by proper training, planning of the operations, and careful attention to detail. We recommend that all prospective implant surgeons attend a device-specific training course and practice in the temporal bone laboratory.

Typical or Atypical Ramsay-Hunt Syndrome in Delayed Facial Palsy After Stapedectomy?

“…According to Shea et al [4] the most probable etio-pathogenetic mechanism for DFP is the activation of a latent herpesvirus in the geniculate ganglion, induced by mechanical stimulation or reactive inflammation of the facial nerve during middle ear surgery. This hypothesis has been supported by many other observations after otological surgical procedures [7][8][9][10][11][12][13][14][15][16][17][18] and preventive antiviral therapy has been proposed in patients with positive history to varicella zoster virus and herpes simplex virus 1 and 2. However, serological search of a viral etiology is often inconclusive, not always identifying which virus (HSV type 1, 2, or VZV) is involved; the proposed use of preventive therapy with antivirals in all stapedectomy patients is still debated and often not applied in clinical practice [4][5][6][7] .…”

“…This hypothesis has been supported by many other observations after otological surgical procedures [7][8][9][10][11][12][13][14][15][16][17][18] and preventive antiviral therapy has been proposed in patients with positive history to varicella zoster virus and herpes simplex virus 1 and 2. However, serological search of a viral etiology is often inconclusive, not always identifying which virus (HSV type 1, 2, or VZV) is involved; the proposed use of preventive therapy with antivirals in all stapedectomy patients is still debated and often not applied in clinical practice [4][5][6][7] .The purpose of this work is to review the relevant literature on DFP after stapedectomy, aiming at properly assessing the viral etiology and at identifying factors that might influence the prognosis or the recovery time or the choice of therapies, and describe a very unusual case of DFP characterized by VZV reactivation showed by the eruption of typical RH lesions. …”

“…n.s. II -60 I Salvinelli F. et al [5] yes HSV- 1 IgM in 1 patient II acyclovir 30 I yes III 30 I yes II 30 I yes III 55 II yes III 270 I yes IV 30 I yes IV 30 I yes IV 20 I Cohen M et al [7] no n.p. VI Steroids (prednisone) 86 I no n.p VI and antiviral >10 I Révész P, et al [6] suspected virus II Steroids 36 I reactivation by heat III (methylprednisolone) 43 I and antiviral Steroids (medrol) and antiviral months, when it reached grade II, then stabilized with minimal residual dynamic dysfunction and slight oculo-oral synkinesis.…”

Cochlear Implants in Children: A Review

“…For children with anatomical deformities of the cochlea (such as Mondini deformity, in which there are less than the normal two and a half turns in the cochlea), the risk of facial nerve damage is greater. However, reported major complication rates are very low, ranging from 2 -5% (Bhatia et al, 2004;Cohen et al, 1989;Loundon et al, 2010).…”

The Suprameatal Approach in Cochlear Implant Surgery: Our Experience with 80 Patients

“…Mastoidectomy and posterior tympanotomy are the main steps in this approach. Posterior tympanotomy is a relatively easy procedure to perform, however it may harbor some potential complications, including facial nerve palsy [2][3][4].…”