Prevalence of Surgical, Anesthetic, and Device-related Complications Among Infants Implanted Before 9 and 12 Months of Age Versus Older Children: Evidence for the Continued Expansion of Pediatric Cochlear Implant Candidacy Criteria

Chweya, Cynthia M.; Smith, Alyssa J.; May, Matthew; Lohse, Christine M.; Neff, Brian A.; Driscoll, Colin L. W.; Carlson, Matthew L.

doi:10.1097/mao.0000000000003060

Cited by 7 publications

(11 citation statements)

References 25 publications

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“…Of these, they had 7 device-related events in which 4 of the issues were device failures out of 89 patients. 45 This is a rate of 4.5%, which is within the range reported in literature (0.2%-6.0%). 56 However, the rate of device migration is 3.3%, which is higher than the rate reported in literature (0.5%-1.3%).…”

Section: Discussionsupporting

confidence: 85%

“…The 18 included studies involved a total of 449 pediatric patients 12 months and younger who underwent 625 cochlear implants (Table 1). 9,12,26,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] Children ranged in age from 4 to 12 months across all studies. Information regarding laterality of cochlear implantation was included in 8 of 18 (44.4%) studies reported, with 124 implants being done on a single side and 89 being done bilaterally.…”

Section: Resultsmentioning

confidence: 99%

“…The study by Chweya et al 45 was the largest series in the meta‐analysis with 89 patients. Of these, they had 7 device‐related events in which 4 of the issues were device failures out of 89 patients 45 . This is a rate of 4.5%, which is within the range reported in literature (0.2%‐6.0%) 56 .…”

Section: Discussionmentioning

confidence: 99%

“…Two studies reported high rates of device‐related complications. The study by Chweya et al 45 was the largest series in the meta‐analysis with 89 patients. Of these, they had 7 device‐related events in which 4 of the issues were device failures out of 89 patients 45 .…”

Section: Discussionmentioning

confidence: 99%

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Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta‐analysis

Sbeih

Bouzaher

Appachi

et al. 2022

Otolaryngol.--head neck surg.

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Objective To systematically review the literature to determine safety of cochlear implantation in pediatric patients 12 months and younger. Data Source Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to March 20, 2021. Review Methods Studies that involved patients 12 months and younger with report of intraoperative or postoperative complication outcomes were included. Studies selected were reviewed for complications, explants, readmissions, and prolonged hospitalizations. Two independent reviewers screened all studies that were selected for the systematic review and meta-analysis. All studies included were assessed for quality and risk of bias. Results The literature search yielded 269 studies, of which 53 studies underwent full-text screening, and 18 studies were selected for the systematic review and meta-analysis. A total of 449 patients and 625 cochlear implants were assessed. Across all included studies, major complications were noted in 3.1% of patients (95% CI, 0.8-7.1) and 2.3% of cochlear implantations (95% CI, 0.6-5.2), whereas minor complications were noted in 2.4% of patients (95% CI, 0.4-6.0) and 1.8% of cochlear implantations (95% CI, 0.4-4.3). There were no anesthetic complications reported across all included studies. Conclusion The results of this systematic review and meta-analysis suggest that cochlear implantation in patients 12 months and younger is safe with similar rates of complications to older cohorts.

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Section: Discussionsupporting

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta‐analysis

Sbeih

Bouzaher

Appachi

et al. 2022

Otolaryngol.--head neck surg.

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“…These changes were driven by ample data supporting the clinical efficacy of CIs compared with hearing aids for younger children with profound hearing loss (4)(5)(6)(7)(8)(9)(10)(11)(12). Furthermore, younger age at time of implantation for children with bilateral profound hearing loss yields better long-term receptive and expressive language outcomes compared with implantation at an older age (13,14). Despite concerns for anesthetic and surgical risks in children younger than 12 months, data suggest persistently low complication rates in this subset of the pediatric patient population (4,10,(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Age and Incidence of Cochlear Implantation in the Pediatric Population With Congenital Bilateral Profound Hearing Loss

Nassiri

Marinelli²,

Lohse

et al. 2023

Otol Neurotol

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Objectives The current study characterizes age and incidence of cochlear implantation among qualifying children with congenital bilateral profound hearing loss in the U.S. Study Design Deidentified cochlear implantation data were acquired from prospectively collected patient registries from two cochlear implant (CI) manufacturers (Cochlear Americas and Advanced Bionics). Children <36 months old were assumed to have congenital bilateral profound sensorineural hearing loss. Setting U.S. CI centers. Patients Children <36 months old who received CIs. Interventions Cochlear implantation. Main Outcome Measures Age at implantation and incidence. Results A total of 4,236 children <36 months old underwent cochlear implantation from 2015 to 2019. The median age at implantation was 16 months (interquartile range, 12–24 mo) and did not change significantly during the 5-year study period (p = 0.09). Patients residing closer to CI centers (p = 0.03) and treated at higher-volume centers (p = 0.008) underwent implantation at a younger age. Bilateral simultaneous implantation increased from 38% to 53% of CI surgeries in 2015 and 2019, respectively. Children who received bilateral simultaneous CIs were younger compared with those receiving unilateral or bilateral sequential CIs (median, 14 versus 18 mo; p < 0.001). The incidence of cochlear implantation increased from 7,648 per 100,000 person-years in 2015 to 9,344 in 2019 (p < 0.001). Conclusion Although the incidence of pediatric CI recipients and the frequency of bilateral simultaneous implantation increased over the study period, age at implantation did not change significantly and far exceeded current Food and Drug Administration (9 mo) and American Academy of Otolaryngology and Head and Neck Surgery position statement (6–12 mo) guidelines.

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The Risk of Meningitis After Cochlear Implantation: A Systematic Review and Meta‐Analysis

Gowrishankar

Fleet

Tomasoni

et al. 2023

Otolaryngol.--head neck surg.

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Objective. This study aims to estimate the rate of postoperative meningitis (both immediate and long-term) in patients following cochlear implants (CIs). It aims to do so through a systematic review and meta-analysis of published studies tracking complications after CIs. Data Sources. MEDLINE, Embase, and Cochrane Library.Review Methods. This review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies tracking complications following CIs in patients were included. Exclusion criteria included non-English language studies and case series reporting <10 patients. Bias risk was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed through DerSimonian and Laird random-effects models.Results. A total of 116/1931 studies met the inclusion criteria and were included in the meta-analysis. Overall, there were 112 cases of meningitis in 58,940 patients after CIs. Metaanalysis estimated an overall rate of postoperative meningitis of 0.07% (95% confidence interval [CIs], 0.03%-0.1%; I 2 = 55%). Subgroup meta-analysis showed this rate had 95% CIs crossing 0% in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, those with postoperative acute otitis media (AOM), and those implanted less than 5 years. Conclusion.Meningitis is a rare complication following CIs. Our estimated rates of meningitis after CIs appear lower than prior estimates based on epidemiological studies in the early 2000s. However, the rate still appears higher than the baseline rate in the general population. The risk was very low in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, received unilateral or bilateral implantations, developed AOM, those implanted with a round window or cochleostomy techniques, and those under 5 years.

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Prevalence of Surgical, Anesthetic, and Device-related Complications Among Infants Implanted Before 9 and 12 Months of Age Versus Older Children: Evidence for the Continued Expansion of Pediatric Cochlear Implant Candidacy Criteria

Abstract: Supplemental Digital Content is available in the text

Cited by 7 publications

References 25 publications

Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta‐analysis

Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta‐analysis

Age and Incidence of Cochlear Implantation in the Pediatric Population With Congenital Bilateral Profound Hearing Loss

The Risk of Meningitis After Cochlear Implantation: A Systematic Review and Meta‐Analysis

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