Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T09:20:41.019Z Has data issue: false hasContentIssue false
  • English
  • Français

Cochlear implant failures: lessons learned from a UK centre

Published online by Cambridge University Press:  28 October 2011

L Masterson ,
S Kumar ,
J H K Kong ,
J Briggs ,
N Donnelly ,
P R Axon  and
R F Gray
L Masterson*
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals Trust, UK
S Kumar
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals Trust, UK
J H K Kong
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals Trust, UK
J Briggs
Affiliation:
Emmeline Hearing Implant Centre, Cambridge University Hospitals Trust, UK
N Donnelly
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals Trust, UK
P R Axon
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals Trust, UK
R F Gray
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals Trust, UK
*
Address for correspondence: Mr Liam Masterson, Department of Otolaryngology, Cambridge University Hospitals, NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK Fax: +44 (0)1223 586 735 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To review our experience of cochlear implant failure and subsequent revision surgery, and to illustrate the experience we have gained by presenting a series of lessons learned.

Methods:

A combined retrospective and prospective study of revision surgery in a UK regional cochlear implant centre.

Results:

Of the 746 cochlear implantations undertaken, 33 (4.7 per cent of adults and 4.1 per cent of children) had a registered failure requiring re-implantation. The mean time to device failure was 60 months in adults and 35 months in children. Causes of cochlear implant failure were medical (n = 11), electrode displacement (n = 2), ‘hard device failure’ (n = 15) and ‘soft device failure’ (n = 5). Chronic suppurative otitis media and post-auricular mastoid abscess were the commonest causes of medical failure. There was one case of electrode array displacement as a direct result of skin flap revision surgery. In 80 per cent of cases, audiological performances were stable or improved following re-implantation.

Conclusion:

As the number of cochlear implants increase and patients outlive the lifespan of their devices, we will face a growing number of revision procedures. Audiologists and otologists should be competent in diagnosing and managing device failure and medical complications requiring cochlear re-implantation.

Keywords

Cochlear ImplantsSurgical RevisionComplicationsOtitis Media
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 1 , January 2012 , pp. 15 - 21
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Balkany, TJ, Hodges, AV, Buchman, CA, Luxford, WM, Pillsbury, CH, Roland, PS et al. Cochlear implant soft failures consensus development conference statement. Cochlear Implants Int 2005;6:105–22CrossRefGoogle ScholarPubMed
2FDA U.S. Food and Drug Administration, Medical Devices. In: http://www.fda.gov/MedicalDevices/default.htm [24 September 2010]Google Scholar
3Cullen, RD, Fayad, JN, Luxford, WM, Buchman, CA. Revision cochlear implant surgery in children. Otol Neurotol 2008;31:74–82Google Scholar
4Marlowe, AL, Chinnici, JE, Rivas, A, Niparko, JK, Francis, HW. Revision cochlear implant surgery in children: the Johns Hopkins experience. Otol Neurotol 2010;31:74–82Google Scholar
5Gosepath, J, Lippert, K, Keilmann, A, Mann, WJ. Analysis of fifty-six cochlear implant device failures. ORL J Otorhinolaryngol Relat Spec 2009;71:142–7CrossRefGoogle ScholarPubMed
6Lassig, AA, Zwolan, TA, Telian, SA. Cochlear implant failures and revision. Otol Neurotol 2005;26:624–34CrossRefGoogle ScholarPubMed
7Cote, M, Ferron, P, Bergeron, F, Bussiere, R. Cochlear reimplantation: causes of failure, outcomes and audiologic performance. Laryngoscope 2007;117:1225–35Google Scholar
8Migirov, L, Taitelbaum-Swead, R, Hildesheimer, M, Kronenberg, J. Revision surgeries in cochlear implant patients: a review of 45 cases. Eur Arch Otorhinolaryngol 2007;264:3–7CrossRefGoogle ScholarPubMed
9Brown, KD, Connell, SS, Balkany, TJ, Eshraghi, AE, Telischi, FF, Angeli, SA. Incidence and indications for revision cochlear implant surgery in adults and children. Laryngoscope 2009;119:152–7CrossRefGoogle ScholarPubMed
10Venail, F, Sicard, M, Piron, J, Levi, A, Artieres, F, Uziel, A et al. Reliability and complications of 500 consecutive cochlear implantations. Otolaryngol Head Neck Surg 2008;134:1276–81Google ScholarPubMed
11Sorrentino, T, Cote, M, Eter, E, Laborde, M, Cochard, N, Deguine, O et al. Cochlear reimplantations: technical and surgical failures. Acta Otolaryngol 2009;129:380–4Google Scholar
12Djalilian, HR, King, T, Faust, RA. Securing cochlear implants to the skull: two alternate methods. Ear Nose Throat J 2001;80:171–3CrossRefGoogle Scholar
13Gibben, KP, Raine, CH, Summerfield AQ. Cochlear implantation: United Kingdom and Ireland surgical survey. Cochlear Implants Int 2003;4:11–21Google Scholar
14Weise, JB, Muller-Deile, J, Brademann, G, Meyer, JE, Ambrosch, P, Maune, S. Impact to the head increases cochlear implant reimplantation rate in children. Auris Nasus Larynx 2005;32:339–43CrossRefGoogle Scholar
15Sunkaraneni, VK, Banerjee, A, Gray, RF. Subdural haematoma: a complication of cochlear implantation. J Laryngol Otol 2004;118:980–2CrossRefGoogle ScholarPubMed
16Bond, M, Mealing, S, Anderson, R, Elston, J, Weiner, G, Taylor, RS et al. The effectiveness and cost-effectiveness of cochlear implants for severe to profound deafness in children and adults: a systematic review and economic model. Health Technol Assess 2009;13:1–212CrossRefGoogle ScholarPubMed
17Sparreboom, M, van Schoonhoven, J, van Zanten, BG. The effectiveness of bilateral cochlear implants for severe-to-profound deafness in children: a systematic review. Otol Neurotol 2010;31:1062–71CrossRefGoogle ScholarPubMed
18Hoffman, RA, Cohen, NL. Surgical pitfalls in cochlear implantation. Laryngoscope 1993;103:741–4Google Scholar
19Clark, GM, Cohen, NL, Shepherd, RK. Surgical and safety considerations of multichannel cochlear implants in children. Ear Hear 1991;12:15–24CrossRefGoogle ScholarPubMed
20Telian, SA, El-Kashlan, HK, Arts, HA. Minimizing wound complications in cochlear implant surgery. Am J Otol 1999;20:331–4Google ScholarPubMed
21Miyamoto, RT, Svirsky, MA, Myres, WA, Kirk, KI, Schulte, J. Cochlear implant reimplantation. Am J Otol 1997;18:60–1Google Scholar