Postoperative complications of cochlear implant: eight years of experience
Main Article Content
Keywords
Cochlear implants, Infection, Replantation
Abstract
Background: Cochlear implant surgery has a low morbidity and mortality. Postoperative complications can be minor and major. Minor complications require conservative management; major complications require reoperation or implant removal. The aim is to determine our complications and compare them with international and Latin American series.
Methods: 275 operated cases were retrospectively analyzed from December 2005 to December 2013. Children and adults between 11 months to 82 years old are included. Demographic data, unilateral or bilateral placement, type of surgery and postoperative complications were evaluated. The follow-up was made for 20 months.
Results: The 57.46 % are children and adolescents, youth and adults are 33.81 %; and 8.73 % are seniors. The complication rate is 12 % (n = 33), 6.91 % for women and 5.09 % for men. There are more complications among 19 to 60 years old. Minor complications account for 7.6 %: local infection (n = 9), delayed transient facial palsy (n = 7), vertigo (n = 3) and tinnitus (n = 2). These are prevalent in children and adults. Major complications are 4.36 %: postoperative hematoma (n = 8), extrusions (n = 2) and inadequate electrode placement (n = 2). These predominate in adults among 19 to 60 years. No deaths or cases of meningitis occurred.
Conclusions: Cochlear implantation has a low incidence of complications. Our results, the only reported at the national level, are comparable with those mentioned in literature.
References
Gluth, M. Implantes Cocleares. En Lalwani A. Diagnóstico y Tratamiento en Otorrinolaringología Cirugía de Cabeza y Cuello. McGraw Hill; 2009. p. 877-887.
Conrado A, Bernal G, Prieto J, Guzmán J. Complicaciones y causas de fallo en cirugía de implante coclear en pacientes del servicio de otorrinolaringología del Hospital Universitario Clínica San Rafael. Acta de Otorrinolaringología CCC 2011; 39(4): 213-224.
Kempf H, Johann K, Lenarz T. Complications in pediatric cochlear implant surgery. Eur Arch Otorhinolaryngol. 1999; 256: 128-132.
Arnoldner C, Baumgartner W, Gstoettner W, Hamzavi J. Surgical considerations in cochlear implantation in children and adults: a review of 342 cases in Vienna. Acta Otolaryngol. 2005; 125 (3): 228-234.
Kempf H, Tempel S, Johann K, Lenarz T. Complications of cochlear implant surgery in children and adults. Laryngorhinootologie. 1999 Oct; 78 (10): 529-37.
Cohen N, Hoffman R. Complications of cochlear implant surgery in adults and children. Ann Otol Rhinol Laryngol. 1991 Sep; 100(9 Pt 1):708-11.
Lassig A, Zwolan T, Telian S. Cochlear implant failures and revision. Otol Neurotol. 2005; 26 (4): 624-634.
Goycoolea, M. et al. Experiencia Latinoamericana con el implante coclear. Rev. Otorrinolaringol. Cir. Cabeza Cuello 2005; 65: 165-172.
Ramos A, Charlone R, De Miguel I, Valdivieso A, Cuyas JM, Pérez D, et al. Complicaciones de la implantación coclear. Acta Otorrinolaringol Esp. 2006; 57: 122-125.
Manrique, M. et al. Implantes cocleares. Real patronato de prevención y atención a personas con minusvalía. Comisión de expertos: comisión española de audifonología (CEAF): SEORL, ANA, FEPAL, AELFA. Comisión para la detección precoz de la hipoacusia (CODEPEH). Federación española de padres y Amigos de los sordos (FIAPAS). Acta Otorrinolaringol Esp 2002; 53: 305-316.
Achiques M, Morant M, Muñoz N, Marco J, Llópez I, Latorre E, et al. Complicaciones y fallos de la implantación coclear. Acta Otorrinolaringológica Española. 2010; 61, Issue 6: 412–417.
Jeppesen J, Emil C. Surgical complications following cochlear implantation in adults based on a proposed reporting consensus. Acta Oto-Laryngologica. 2013; 133: 1012-1021.
Tambyraja R, Gutman M, Megerian C. Cochlear implant complications: utility of federal database in systematic analysis. Arch Otolaryngol Head Neck Surg. 2005; 131: 245-250.
Yu KC, Hegarty J, Gantz B, Lalwani A. Conservative management of infections in cochlear implant recipients. Otolaryngol Head Neck Surg. 2001; 125: 66-70.
Shea JJ III, Domico EH. Facial nerve stimulation after successful multichannel cochlear implantation. Am J Otol. 1994; 15 (6): 752-756.
European consensus statement on cochlear implant failures and explantations. Otol Neurotol. 2005; 26: 1097-1099.
Wang, J. T., Wang, A. Y., Psarros, C. and Da Cruz, M. (2014), Rates of revision and device failure in cochlear implant surgery: A 30-year experience. The Laryngoscope, 124: 2393-2399.
Qiu J, Chen Y, Tan P, Chen J, Han Y, Gao L, et al. Complications and clinical analysis of 416 consecutive cochlear implantations. Int J Pediatr Otorhinolaryngol. 2011 Sep; 75(9):1143-6.
Ciorba A, Bovo R, Trevisi P, Rosignoli M, Aimoni C, Castiglione A, et al. Postoperative complications in cochlear implants: a retrospective analysis of 438 consecutive cases. Eur Arch Otorhinolaryngol. 2012 Jun; 269(6):1599-603.
Hansen S, Anthonsen K, Stangerup SE, Jensen JH, Thomsen J, Cayé-Thomasen P. Unexpected findings and surgical complications in 505 consecutive cochlear implantations: a proposal for reporting consensus. Acta Otolaryngol. 2010 May; 130(5): 540-9.
Manrique M, Ramos A, Morera C, Cenjor C, Lavilla M, Boleas M et al. Evaluación del implante coclear como técnica de tratamiento de la hipoacusia profunda en pacientes pre y post locutivos. Acta Otorrinolaringológica Española. Volume 57, Issue 1, 2006, Pages 2-23.
Lima J, Rodrigues J, Calhau CM, Calhau AC, Palhano CT. Postoperative complications in implanted patients in the Cochlear Implant Program of Rio Grande do Norte-Brazil. Braz J Otorhinolaryngol. 2010 Jul-Aug;76(4):517-21.
Zernotti M, Suárez A , Slavutsky V, Nicenboim L, Di Gregorio MF, Soto J. Comparación de complicaciones según la técnica utilizada en los implantes cocleares. Acta Otorrinolaringológica Española, Volume 63, Issue 5, Pages 327-331.
Ikeya J, Kawano A, Nishiyama N, Kawaguchi S, Hagiwara A, Suzuki M. Long-term complications after cochlear implantation. Auris Nasus Larynx. 2013 Dec;40(6):525-9.
Velandia R, Rivas J, Rivas A, Forero V. Complicaciones en el implante coclear pediátrico en la Clínica José A. Rivas. Bogotá – Colombia. Acta de Otorrinolaringología & Cirugía de Cabeza y Cuello. 2013; 41(1): 32-35.