Reliability of cochlear implants

Maurer, Jan; Marangos, Nicolaos; Ziegler, Erin

doi:10.1016/j.otohns.2005.01.026

Cited by 35 publications

(20 citation statements)

References 5 publications

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“…Audiologic judgment in optimizing reception, device defect, and cochlear anatomy may prompt electrode deactivation. Device malfunction required revision surgery in 2.4% of implanted ears at a mean interval of 12 months after implantation, which is slightly lower than the rate reported by Maurer et al (14) for the first year (3.6%). Whether or not an early trend of electrode deactivation is a predictor of future device failure is under prospective examination in this Childhood Development after Cochlear Implantation study.…”

Section: Discussioncontrasting

confidence: 55%

Surgical Factors in Pediatric Cochlear Implantation and Their Early Effects on Electrode Activation and Functional Outcomes

Francis¹,

Buchman²,

Visaya³

et al. 2008

Otology &Amp; Neurotology

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Objective-To assess the impact of surgical factors on electrode status and early communication outcomes in young children in the first 2 years of cochlear implantation.Study Design-Prospective multicenter cohort study. Setting-Six tertiary referral centers.Patients-Children 5 years or younger before implantation with normal nonverbal intelligence. Intervention-Cochlear implant operations in 209 ears of 188 children.Main Outcome Measures-Percent active channels, auditory behavior as measured by the Infant Toddler Meaningful Auditory Integration Scale/Meaningful Auditory Integration Scale and Reynell receptive language scores.Results-Stable insertion of the full electrode array was accomplished in 96.2% of ears. At least 75% of electrode channels were active in 88% of ears. Electrode deactivation had a significant negative effect on Infant Toddler Meaningful Auditory Integration Scale/Meaningful Auditory Integration Scale scores at 24 months but no effect on receptive language scores. Significantly fewer active electrodes were associated with a history of meningitis. Surgical complications requiring additional hospitalization and/or revision surgery occurred in 6.7% of patients but had no measurable effect on the development of auditory behavior within the first 2 years. Negative, although insignificant, associations were observed between the need for perioperative revision of the device and 1) the percent of active electrodes and 2) the receptive language level at 2-year follow-up.Conclusion-Activation of the entire electrode array is associated with better early auditory outcomes. Decrements in the number of active electrodes and lower gains of receptive language after manipulation of the newly implanted device were not statistically significant but may be clinically relevant, underscoring the importance of surgical technique and the effective placement of the electrode array. Multiple factors likely influence speech perception and language outcomes after early cochlear implantation (1,2). Medical, surgical, and anatomic factors may contribute to variability in these outcomes as suggested by the influence of electrode position on speech perception results in adults (3,4). Although long-term morbidity rarely results from perioperative complications (5-7), the long-term effects on device function and patient outcome are less clear. The present report examines whether optimization of surgical implantation represents an opportunity for greater implant benefit.We considered surgery-related variables, including cochlear anatomy, cause, and complications alongside other child, environmental, and device variables to assess effects on auditory behavior and receptive language at 2 years after surgery. Our goal was to examine how surgical factors relate to device function and their early effects on auditory performance and verbal language comprehension. Methods Study PopulationThe Childhood Development after Cochlear Implantation study is a multicenter prospective cohort study designed to analyze the predictive val...

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Section: Discussioncontrasting

confidence: 55%

Surgical Factors in Pediatric Cochlear Implantation and Their Early Effects on Electrode Activation and Functional Outcomes

Francis¹,

Buchman²,

Visaya³

et al. 2008

Otology &Amp; Neurotology

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“…There should be no reason for patients, and/or parents for their child, to reject cochlear implantation, as nowadays the risks linked to this type of surgery are relatively low [5,9,[16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Postoperative complications in cochlear implants: a retrospective analysis of 438 consecutive cases

Ciorba

Bovo

Trevisi

et al. 2011

Eur Arch Otorhinolaryngol

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Our objective is to determine the complication rate in a population of infants, children, adolescents and adults, from a University Hospital Cochlear Implant program and to discuss their causes and treatments. The methods include a retrospective study of 438 consecutive patients in a tertiary referral centre, the Audiology Department of the University Hospital of Ferrara. All patients receiving cochlear implants, between 1 January 2003 and 31 December 2009, have been included. All complications and treatments were systematically reviewed with an average duration of follow-up of 46 months (range 10-84 months). The results reveal that the overall rate of complications in our group was 9.1% (40 of 438), and most of them were minor. Wound swelling and infections represent the most common complication occurred. There were no cases of transient or permanent facial palsy following surgery, and also we did not register any case of postsurgical meningitis. Thirteen patients (3.0%) underwent explantation followed by reimplantation. In conclusion, we find that Cochlear implantation is a safe low-morbility technique with a relatively low complication rate in the presented population.

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“…In an earlier investigation from our institution, Maurer et al [9] retrospectively analyzed long-term reliability in 192 consecutive cochlear implants over a period of 11 years and reported an overall failure rate of even 18.3%. Looking at the 4 different device manufacturers, it becomes obvious that although the respective numbers of implantations are not comparable, in the present study we saw a marked difference in the overall implant failure rates between the most commonly used devices, which were Med-EL (16.2% revisions) and Nucleus (4.2% revisions).…”

Section: Discussionmentioning

confidence: 99%

Analysis of Fifty-Six Cochlear Implant Device Failures

Gosepath

Lippert²,

Keilmann³

et al. 2009

ORL

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Objective: Our aim was to present a failure analysis after cochlear implant revision surgery in a large series of children and adults and to assess the outcome and audiologic performance. Methods: Fifty-six cochlear implant failures that occurred in 422 devices implanted between 1990 and 2007 at the Department of Otolaryngology, Head and Neck Surgery at the University of Mainz, Germany, were retrospectively analyzed. The causes of failure were reviewed evaluating the individual history, telemetric and intraoperative findings and manufacturer’s investigation reports. Results: We performed 56 surgical revisions in a series of 422 consecutive implants (overall revision rate: 13.27%). The most frequent causes for revision were hard failures (58.9%), most commonly caused by traumatic impact (37.5%), especially in the pediatric population. Soft failures were less frequent (21.4%). Surgical reimplantations, although challenging in some cases, were performed without complications and with an electrode insertion depth comparable to that at the time of the initial implantation in all patients. The average audiologic performance improved by 2.4 dB in pure-tone perception levels after reimplantation. Conclusion: The cochlear implant failure rates vary between children and adults as well as between different implant manufactures. However, cochlear reimplantation is safe with excellent and predictable results in audiologic performance.

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Reliability of cochlear implants

Cited by 35 publications

References 5 publications

Surgical Factors in Pediatric Cochlear Implantation and Their Early Effects on Electrode Activation and Functional Outcomes

Surgical Factors in Pediatric Cochlear Implantation and Their Early Effects on Electrode Activation and Functional Outcomes

Postoperative complications in cochlear implants: a retrospective analysis of 438 consecutive cases

Analysis of Fifty-Six Cochlear Implant Device Failures

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