Revision pediatric cochlear implantation in a large tertiary center since 1986. (1st November 2020)

• Record Type: Journal Article
• Authors: Kou, Yann-Fuu; Hunter, Jacob B.; Kutz, Joe Walter; Isaacson, Brandon; Lee, Kenneth H.
• Is Part Of: Cochlear implants international. Volume 21:Number 6(2020)
• Page Start: 353
• Page End: 357
• Publication Date: 2020-11-01
• Subjects: Cochlear implantation -- Pediatric -- Revision surgery -- Speech outcomes; Cochlear implants -- Periodicals; 617.882
• DOI: 10.1080/14670100.2020.1788860
• Languages: English
• ISSNs: 1467-0100

Abstract

Abstract : Objective: To identify the rate of cochlear implantation (CI) re-implantation and assess audiologic outcomes. Methods: Demographic, audiometric, radiographic, and clinical data were collected from the medical records of the first 834 pediatric patients (age < 18) who underwent CI at a tertiary-care center. Results: Reviewing the first 834 pediatric patients who underwent CI between 1986 and 2013, 33 (4%) children have required re-implantation. Seven (0.8%) of these required a second re-implantation, for a total of 40 total revision surgeries (4.8%) and 21.1% of patients who underwent revision required multiple re-implantations. The mean age at initial CI was 3.5 years old, with identification of the failure an average of 2.7 years later (range, 0.1–10.1 years). The most common indications for re-implantation CI were unknown etiology (58%), vendor recall (18%), and trauma (9%). Twenty-three (88.5%) of the 26 patients who underwent only one re-implantation surgery achieved a complete insertion with both procedures. Eleven (91.7%) of 12 patients who had open set speech after their initial procedure maintained this after re-implantation surgery. Eight (38.1%) of 21 patients who did not have open-set speech after their initial implantation achieved open set speech with CI re-implantation. Conclusion: CI re-implantation is not common in the pediatric population. However, given the time-sensitive nature of speech/language development in children, with the right indications, CI re-implantation can be performed safely without compromising audiologic outcomes. However, re-implanted patients have an increased risk they will require re-implantation again in the future.