ABSTRACT
Background: Cochlear implantation has been evolved as the management of choice in patients with bilateral severe to profound sensorineural hearing loss in both children and the elderly population. Children who undergo cochlear implantation early in life, followed by appropriate rehabilitation have improved communication and learning skills. Aim of the study: In this study, we review the anesthetic management of seven cases of pediatric cochlear implantation done in our institution in the last one year. Materials and methods: Randomized control study was done at Government Stanley Medical College Hospital, Chennai, Tamil Nadu (January 2018). Intraoperative facial nerve integrity testing was not done for any of our cases. The nasopharyngeal temperature was monitored. To prevent hypothermia, forced air warmer was used. In our institution, stimulation techniques to identify facial nerve were not used for any of the cases. The intraoperative period was uneventful in all cases. Hemodynamics was maintained in all the cases in order to provide a bloodless surgical field. Results: No patients had emergence agitation. Post-operative analgesia was achieved with paracetamol rectal suppositories. No children had postoperative shivering. All children were followed up after discharge for stimulation of electrodes and speech therapy. Presence of mental retardation should be assessed as it may be associated with a retrocochlear hearing loss. Counseling was an important part of the pre-operative period to improve the outcome. Conclusion: Cochlear implantation is a specialized surgery and anesthesiologist’s awareness of the pitfalls and resourcefulness in dealing with communication impaired, pediatric age group makes the task challenging. The procedure itself has no significant anesthetic complications provided a thorough preoperative evaluation and good conduct of anesthesia is done.