Cochlear implant complications in 403 patients: comparative study of adults and children and review of the literature

Eur Ann Otorhinolaryngol Head Neck Dis. 2014 Jun;131(3):177-82. doi: 10.1016/j.anorl.2013.05.005. Epub 2014 Jun 2.

Abstract

Objectives: The purpose of this study was to assess the postoperative complications related to cochlear implants and to discuss the differences observed between adult and paediatric populations. Cochlear implant complications were defined as any pathological events observed during the postoperative period, whether or not they were directly related to the surgical technique. We therefore recorded all complications, in the broad sense of the term, ranging from acute otitis media to cochlear explantation.

Study design: Retrospective analysis of cochlear implant patients.

Material and methods: All surgical procedures (unilateral or bilateral cochlear implantation, revision surgery) performed in our institution between March 1993 and January 2013 were reviewed. This population comprised 168 adults (median age at the time of implantation: 51.9 years), and 235 children (median age at the time of implantation: 4.5 years). All postoperative complications were classified as either major (requiring surgical revision or hospital management) or minor (requiring conservative management).

Results: The global complication rate was 19.9% (80/403 cases), comprising 5% of major complications (20 cases) and 14.9% of minor complications (60 cases). This complication rate was significantly higher in the adult population (P=0.004).

Conclusion: Cochlear implantation is a safe hearing rehabilitation surgical technique associated with a low complication rate. However, surgeons must be familiar with these complications in order to ensure optimal prevention. Minor complications were mainly infectious in children (acute otitis media) and cochleovestibular in adults (tinnitus and vertigo). Major complications were mostly reimplantation following revision surgery or device failure. Only the minor complication rate was significantly higher in the adult population.

Keywords: Adults; Children; Cochlear implant; Device failures; Postoperative complications.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cholesteatoma / etiology
  • Cochlear Implantation / adverse effects*
  • Cochlear Implants / adverse effects*
  • Facial Paralysis / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Meningitis, Bacterial / etiology
  • Middle Aged
  • Otitis / etiology
  • Prosthesis Failure
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Surgical Wound Infection / etiology
  • Taste Disorders / etiology
  • Tinnitus / etiology
  • Ulcer / etiology
  • Young Adult