Pain in cochlear implant recipients: An uncommon, yet serious, consequence of cochlear implantation

Shapira, Yehoshua; Yaar-Soffer, Yifat; Hildesheimer, Minka; Migirov, Lela; Henkin, Yael

doi:10.1002/lary.25272

Cited by 15 publications

(19 citation statements)

References 25 publications

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“…Review articles focused on delayed complications of cochlear implantation found that only 48 (0.9%) of 5486 patients developed seromas or hematomas, the majority of which required only conservative therapy. 1,2 Delayed onset of pain and hematoma formation after cochlear implantation, which are complications encountered in this case report, are issues that are rarely encountered. 3 Current treatment strategies suggest conservative hematoma evacuation through needle aspiration and additional diagnostic procedures to account for underlying etiological factors such as infection, coagulopathies, or repeated head trauma.…”

Section: Discussionmentioning

confidence: 83%

“…Some authors also suggest that delayed-onset pain should be considered a major complication since a significant amount of these patients require revision surgery. 2 Another recent report on 5 patients with delayed onset of pain in the region surrounding the implant showed that revision surgery and device explantation relieved the symptoms. Subsequent reimplantation was uneventful and no reason for initial pain onset could be identified.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Case Report of Delayed Onset Spontaneous Hematoma, Pain, and Temporal Bone Neo-Ossification 16 Years After Cochlear Implantation

2019

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

A Case Report of Delayed Onset Spontaneous Hematoma, Pain, and Temporal Bone Neo-Ossification 16 Years After Cochlear Implantation

2019

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“…The incidence of chronic or recurrent pain for BAHS patients is reported to be between 1.2-4.2% (van der Pouw et al, 1998;Badran et al, 2009;Siau et al, 2012;Caspers et al, 2019). Similarly, delayed and persistent pain around a cochlear implant (CI) receiver/stimulator occurs in 2.8% of patients (Shapira et al, 2015). Even though the reason for the pain could not be determined for these CI patients, the authors speculated that biofilm formation on the implant or loss of hermicity could be explanations.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Analysis of the Tissue Response to a Bone-Anchored Hearing Implant: Presentation of a Two-Year Case Report of a Patient With Recurrent Pain, Inflammation, and Infection, Including a Systematic Literature Review

Johansson

Calon

Omar

et al. 2021

Front. Cell. Infect. Microbiol.

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Osseointegration is a well-established concept used in applications including the percutaneous Bone-Anchored Hearing System (BAHS) and auricular rehabilitation. To date, few retrieved implants have been described. A systematic review including cases where percutaneous bone-anchored implants inserted in the temporal bone were retrieved and analyzed was performed. We also present the case of a patient who received a BAHS for mixed hearing loss. After the initial surgery, several episodes of soft tissue inflammation accompanied by pain were observed, leading to elective abutment removal 14 months post-surgery. Two years post-implantation, the implant was removed due to pain and subjected to a multiscale and multimodal analysis: microbial DNA using molecular fingerprinting, gene expression using quantitative real-time polymerase chain reaction (qPCR), X-ray microcomputed tomography (micro-CT), histology, histomorphometry, backscattered scanning electron microscopy (BSE-SEM), Raman spectroscopy, and fluorescence in situ hybridization (FISH). Evidence of osseointegration was provided via micro-CT, histology, BSE-SEM, and Raman spectroscopy. Polymicrobial colonization in the periabutment area and on the implant, including that with Staphylococcus aureus and Staphylococcus epidermidis, was determined using a molecular analysis via a 16S-23S rDNA interspace [IS]-region-based profiling method (IS-Pro). The histology suggested bacterial colonization in the skin and in the peri-implant bone. FISH confirmed the localization of S. aureus and coagulase-negative staphylococci in the skin. Ten articles (54 implants, 47 patients) met the inclusion criteria for the literature search. The analyzed samples were either BAHS (35 implants) or bone-anchored aural epitheses (19 implants) in situ between 2 weeks and 8 years. The main reasons for elective removal were nonuse/changes in treatment, pain, or skin reactions. Most samples were evaluated using histology, demonstrating osseointegration, but with the absence of bone under the implants’ proximal flange. Taken together, the literature and this case report show clear evidence of osseointegration, despite prominent complications. Nevertheless, despite implant osseointegration, chronic pain related to the BAHS may be associated with a chronic bacterial infection and raised inflammatory response in the absence of macroscopic signs of infection. It is suggested that a multimodal analysis of peri-implant health provides possibilities for device improvements and to guide diagnostic and therapeutic strategies to alleviate the impact of complications.

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“…Therefore, he underwent explantation. Shapira et al 13 reported a case series of patients in which pain over the receiver was described as a mild delayed complication in 2.8% of 1044 implants. Magnet reposition due to magnet dislocation resulting from head trauma, was reported in the current study.…”

Section: Number Of Total Implantsmentioning

confidence: 99%

Clinical profile and management of revision cochlear implant surgeries

Aldhafeeri

Alzhrani

Alajlan

et al. 2021

SMJ

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Objectives: To discuss our experience with managing cochlear implant cases that required revision surgery. Methods: A retrospective case series study including data from 922 cochlear implant patients at an academic tertiary center was evaluated retrospectively. All patients who underwent revision cochlear implant (CI) surgery between January 2011 and July 2017 were included. The following data were collected: patient demographic data, details on the first implant, reasons for the revision, duration from initial implantation to revision, type of device, and management. Results: Out of 922 CI patients, 37 (4%) underwent revision surgery, comprising 33 children and 4 adults. The most common reason for revision surgery, at 28/37 cases (75.6%), was device failure. Surgical and medical aetiologies were responsible for 9/37 (24.3%) revisions. The mean duration from the initial implantation to the revision surgery was 29 months. Conclusion: Revision CI surgery is not uncommon after initial implantation. Cochlear implant programs must implement long-term follow-up processes for CI users. Whenever a patient's rehabilitated performance regresses, the cause should be investigated to determine whether subsequent reimplantation is necessary.

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Pain in cochlear implant recipients: An uncommon, yet serious, consequence of cochlear implantation

Abstract: 4.

Cited by 15 publications

References 25 publications

A Case Report of Delayed Onset Spontaneous Hematoma, Pain, and Temporal Bone Neo-Ossification 16 Years After Cochlear Implantation

A Case Report of Delayed Onset Spontaneous Hematoma, Pain, and Temporal Bone Neo-Ossification 16 Years After Cochlear Implantation

Multimodal Analysis of the Tissue Response to a Bone-Anchored Hearing Implant: Presentation of a Two-Year Case Report of a Patient With Recurrent Pain, Inflammation, and Infection, Including a Systematic Literature Review

Clinical profile and management of revision cochlear implant surgeries

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