The cases of complications after cochlear implantation

Abstract

The objective of study: To improve the methods of surgical stage of cochlear implantation by means of analysis of clinical findings during incorrect insertion of the active electrode into the spiral canal of the cochlea and the decision on such patients management. Materials and methods: At the period of 2014 through 2016, 920 patients aged 8 months to 24 years, were examined and operated on in the Federal State Budgetary Institution Clinical Research Centre of Otorhinolaryngology of the Russian Federation and the Hospital of the Ministry of Internal Affairs named after A. Hejdarov of the Republic of Azerbaijan in the framework of cochlear implantation program. Results: The authors revealed 4 cases of incorrect insertion of the active electrode into the cochlea. Of them, 3 cases have been observed in children aged 3–6 years with the abnormalities of the inner ear development and 1 case in an adult patient with the normal temporal bone anatomy. Each of the 4 cases required repeated surgery. Conclusion: Improper positioning of the electrode grid should be included in the differential diagnosis in cases that even in several years after the implantation the patients have no hearing improvement. Extracochlear displacement of active electrode is a rare complication, the published incidence is in average 0.37% [16]. However, this range is probably underestimated, and the true incidence may remain unknown until universal centralized database for recording of such cases is created. In majority of such cases described in the literature and in this study the management approach is explantation and reimplantation.