Rates of revision and device failure in cochlear implant surgery: A 30‐year experience

Wang, Jeffrey T.; Wang, Allen Y.; Psarros, Colleen; Cruz, María de la

doi:10.1002/lary.24649

Cited by 134 publications

(136 citation statements)

References 44 publications

(67 reference statements)

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“…Intrusion, which results in deeper insertion, may cause greater intracochlear trauma and impair residual hearing [Adunka et al, 2004;Gstöttner et al, 2005]. Apart from device failure, extrusion of the electrode array is the second most relevant indication for reimplantation [Connell et al, 2008;Rivas et al, 2008;Wang et al, 2014]. Different techniques to avoid electrode and device migration are known.…”

Section: Electrode Migration In Patients Withmentioning

confidence: 99%

Electrode Migration in Patients with Perimodiolar Cochlear Implant Electrodes

Mittmann¹,

Rademacher

Mutze

et al. 2015

Audiol Neurotol

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Migration of a cochlear implant electrode is a hitherto uncommon complication. So far, array migration has only been observed in lateral wall electrodes. Between 1999 and 2014, a total of 27 patients received bilateral perimodiolar electrode arrays at our institution. The insertion depth angle was estimated on the initial postoperative scans and compared with the insertion depth angle of the postoperative scans performed after contralateral cochlear implantation. Seven (25.93%) patients were found to have an electrode array migration of more than 15°. Electrode migration in perimodiolar electrodes seems to be less frequent and to occur to a lower extent than in lateral wall electrodes. Electrode migration was clinically asymptomatic in all cases.

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Section: Electrode Migration In Patients Withmentioning

confidence: 99%

Electrode Migration in Patients with Perimodiolar Cochlear Implant Electrodes

Mittmann¹,

Rademacher

Mutze

et al. 2015

Audiol Neurotol

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“…The costs for the “no CI” group were assumed entirely out-of-pocket, and were weighed according to the proportions of bilateral HA users, unilateral HA users, and HA non-users, observed at the baseline (pre-CI use) of the CUA substudy. The model also assumed 100% of CI revision surgeries were CI reimplantations, whereas recent evidence suggest this rate to be 85.5% (19). CI reimplantation surgeries are often more costly than other types of CI revision surgeries (19).…”

Section: Discussionmentioning

confidence: 99%

“…The model also assumed 100% of CI revision surgeries were CI reimplantations, whereas recent evidence suggest this rate to be 85.5% (19). CI reimplantation surgeries are often more costly than other types of CI revision surgeries (19). …”

Section: Discussionmentioning

confidence: 99%

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Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China

Qiu

Ariyaratne

et al. 2017

Otology &Amp; Neurotology

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Objectives:To evaluate the cost utility of cochlear implantation (CI) for severe to profound sensorineural hearing loss (SNHL) among children from rural settings in P.R. China (China).Research Design:A cost-utility analysis (CUA) was undertaken using data generated from a single-center substudy of the CochlearTM Pediatric Implanted Recipient Observational Study (Cochlear P-IROS). The data were projected over a 20-year time horizon using a decision tree model.Setting:The Chinese healthcare payer and patient perspectives were adopted.Intervention:Unilateral CI of children with a severe-to-profound SNHL compared with their preimplantation state of no treatment or amplification with hearing aids (“no CI” status).Main Outcome Measure/s:Incremental costs per quality adjusted life year (QALY) gained.Results:The mean total discounted cost of unilateral CI was CNY 252,506 (37,876 USD), compared with CNY 29,005 (4,351 USD) for the no CI status from the healthcare payer plus patient perspective. A total discounted benefit of 8.9 QALYs was estimated for CI recipients compared with 6.7 QALYs for the no CI status. From the healthcare payer plus patient perspective, incremental cost-effectiveness ratio (ICER) for unilateral CI compared with no CI was CNY 100,561 (15,084 USD) per QALY. The healthcare payer perspective yielded an ICER of CNY 40,929 (6,139 USD) per QALY. Both ICERs fell within one to three times China's gross domestic product per capita (GDP, 2011–2015), considered “cost-effective” by World Health Organization (WHO) standards.Conclusions:Treatment with unilateral CI is a cost-effective hearing solution for children with severe to profound SNHL in rural China. Increased access to mainstream education and greater opportunities for employment, are potential downstream benefits of CI that may yield further societal and economic benefits. CI may be considered favorably for broader inclusion in medical insurance schemes across China.

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“…As the number of patients receiving CIs increases, so does the need for primary and revision operations. The current rate of revision is between 3% and 8% for cochlear implantation operations 15. Several studies have demonstrated that the leading reason for seeking revision surgery is implant failure 15–18.…”

Section: Discussionmentioning

confidence: 99%