Pain After Cochlear Implantation: An Unusual Complication?

Celerier, Charlotte; Rouillon, Isabelle; Blanchard, M.; Parodi, M.; Denoyelle, Françoise; Loundon, Natalie

doi:10.1097/mao.0000000000001451

Cited by 21 publications

(30 citation statements)

References 21 publications

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“…Bacteria rapidly form a biofilm on the surface of the foreign body, and bacteria in biofilm can be difficult to eradicate with antibiotic treatment as they multiply slowly and are protected against antibiotics due to enhanced antibiotic tolerance and resistance [19][20][21]. The formation of biofilm may be an explanation for the small increase in the incidence of prolonged postoperative pain found in our study as an association between biofilm and pain has also been demonstrated by others evaluating prolonged pain after temporary or permanent synthetic implant placement [22,23]. However, in actual numbers the incidence with or without antibiotic prophylaxis was low at 0.4% and 0.6%, respectively.…”

Section: Discussionsupporting

confidence: 73%

Is antibiotic prophylaxis necessary in mid-urethral sling surgery?

et al. 2020

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Introduction and hypothesis Antibiotic prophylaxis is commonly used when implanting a mid-urethral sling (MUS) for female stress urinary incontinence. Use of antibiotics may lead to adverse events and the development of antibiotic resistance. This study compared a variety of outcomes after MUS surgery with and without antibiotic prophylaxis using data from the national Norwegian Female Incontinence Registry. Methods Preoperative and 6–12 months postoperative subjective and objective data from 28,687 patients who received MUS surgery from 1998 through 2017 were extracted from the registry. Categorical outcomes were compared between women with or without antibiotic prophylaxis using chi-square test for independence. Primary outcome was incidence of postoperative surgical site infection (SSI). Secondary outcomes were incidence of tape exposure, de novo or persistent urgency urinary incontinence, postoperative pain > 3 months, subjective and objective cure rates, and patient satisfaction. Results Antibiotic prophylaxis was used in 9131 and not used in 19,556 patients. SSIs and prolonged postoperative pain occurred significantly more often without antibiotic prophylaxis. Subjective and objective cure rates were significantly higher and tape exposures significantly lower in women not receiving prophylactic antibiotics. There were no significant differences in other outcomes. Conclusions Antibiotic prophylaxis resulted in fewer women developing postoperative infections or prolonged postoperative pain after MUS surgery, but did not offer protection against tape exposure. The differences in cure rates were small and probably without clinical relevance. If a small increase in surgical site infections is accepted, the routine use of antibiotic prophylaxis can probably be omitted.

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Section: Discussionsupporting

confidence: 73%

Is antibiotic prophylaxis necessary in mid-urethral sling surgery?

et al. 2020

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“…Because, the patients with soft failure have non-specific and unproven complaints such as pain, tinnitus or intermittent interruption of signals. In this situation, all of in vivo and ex vivo tests are normal and the only thing that shows that the problem is in the device, replacing the device can correct all complaints [6,27]. In our two cases (patient 1 and 10), we thought soft failure before the revision surgery.…”

Section: Discussionmentioning

confidence: 77%

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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“…In this regard, transcutaneous ultrasound is a valuable imaging modality that avoids radiation exposure and has been described for the diagnostic workup of haematoma around the CI and for detecting magnet dislocation [16][17][18]. However, the literature on the feasibility and reliability of ultrasound in other CI complications has so far been limited to a few case reports [13,19,20].…”

Section: Discussionmentioning

confidence: 99%

“…Although many studies have focused on the surgical and medical complications that occur after cochlear implantation [4][5][6]10], data on imaging methods for the optimal diagnostic workup of these complications is limited and inconclusive. Mostly, temporal bone computed tomography (CT) or X-ray examination is recommended when dealing with cochlear implant (CI) complications [7,8,[11][12][13][14]. In this context, 82.4% of CT scans showed no abnormalities in CI complications but exposed the patients to radiation [15].…”

Section: Introductionmentioning

confidence: 99%

Diagnosing complications following cochlear implantation using transcutaneous ultrasound

Rupp

Thimsen

Balk

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose The aim of this study was to investigate the feasibility and reliability of transcutaneous ultrasound for the detection of complications after cochlear implantation. Methods In a single center retrospective cohort study, 115 consecutive cases of suspected complications after cochlear implantation (intervention group) were examined. The rate of pathologic ultrasound findings for specific leading symptoms and diagnoses was compared to a control group comprising twenty consecutive cochlear implants in symptom-free patients. Results Diagnostic ultrasound showed distinctly more pathologic findings in the intervention group (n = 67; 58.3%; p < 0.001) compared to the control group (n = 1; 5%). Ultrasound revealed significantly more pathologic findings in haematoma or seroma around the implant (n = 17; 100%; p < 0.001; ϕ = 0.94) and magnet dislocation (n = 44; 97.7%; p < 0.001; ϕ = 0.92) confirmed by a strong effect. Ultrasound examination showed a medium to high effect size in patients presenting with local infections (n = 3; 21.4%; p = 0.283; ϕ = 0.25) and skin flap oedema (n = 2; 50%; p = 0.061; ϕ = 0.51). In contrast, ultrasound examinations displayed a low effect size in undefined cephalgia (0%; p = 0.444; ϕ = 0.17) and device malfunction or failure (0%; p > 0.999; ϕ = 0.13). Conclusion Transcutaneous ultrasound can be advocated as a feasible and effective method in the diagnostic work-up of magnet dislocation and haematoma or seroma around the implant following cochlear implantation. Contrary, ultrasound findings can be expected to be inconspicuous in patients presenting with undefined cephalgia and device malfunction or failure.

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Pain After Cochlear Implantation: An Unusual Complication?

Abstract: Pain in the implanted area can be a major complication leading to implant non-use. Rate may be underestimated because of the lack of medical report. At explantation, we recommend systematic evaluation of biofilm and device failure regardless of the suspected etiology of the pain.

Cited by 21 publications

References 21 publications

Is antibiotic prophylaxis necessary in mid-urethral sling surgery?

Is antibiotic prophylaxis necessary in mid-urethral sling surgery?

Cochlear Implant Failure in the Pediatric Population

Diagnosing complications following cochlear implantation using transcutaneous ultrasound

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