Revision Cochlear Implant Surgery in Patients With Suspected Soft Failures

Abstract

Our cochlear revision series are comparable to what is reported in the literature. However, an unexpected relationship between meningitis was identified among our soft failure group. More than one-quarter carried a history of meningitis. Moreover, nearly one-half of all soft failures had some form of inflammatory derangement. We used the soft failure criteria established by the 2005 Consensus Development Conference for our population analysis. Although we agree that audiologic data often are essential for defining soft failure, multiple patients in our series experienced pain that was severe enough to prevent a complete audiometric evaluation, therefore not rigorously fulfilling the criteria set forth by the 2005 Consensus. However, because their symptoms resolved after reimplantation, and their speech performance restored, we propose modifications of the current definition of "soft failure" to include these patients.

Complications in a series of 4400 paediatric cochlear implantation

“…Surgeons have to know several areas of potential risk. As reported in the literature, the most common aetiology for reoperation is device failure [8], our results is 2.3% and are comparable to the reports of Chung et al [9] and Donatelli and Tresa [8]. Recently, Trotter et al [10] reported that the rate of device failure has been reduced; this might be the result of improvements in the manufacturing process.…”

Symptom Timeline Preceding Cochlear Implant Failure

“…A consensus statement was issued in 2005 to define a soft failure as the following: exclusion of hardware-or softwarerelated causes of performance deterioration, exclusion of medical problems that results in implant failure, radiographic evidence of proper implant and electrode placement, and return of function with subsequent reimplantation. 2,3 Medical failures generally include infection and wound dehiscence. Implant failure rates in the past have been estimated as low as 1.5% to as high as 15%, although it is difficult to compare the failure rates between many studies because some consider any revision surgery a failure, some consider only implants that must be explanted a failure, some limit which brand is reviewed, and others consider only hard device failures as true failures.…”

Histopathological Effects of Parylene C (poly-chloro-p-xylylene) in the Inner Ear

“…The causes of cochlear implant failure are extrusion and malpositioning of the implant electrode, wound and flap problems, and trauma (13)(14)(15)(16). In addition, few authors have mentioned that allergy to silicon is one of the causes of cochlear implant extrusion (7-9).…”