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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]
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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

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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