ABSTRACT
Electrode array misplacement is a rare complication of cochlear implant. This article reports an 11-year-old boy who was mistakenly implanted the cochlear electrode array into the superior semicircular canal during the initial cochlear implant. After the diagnosis was confirmed, he underwent a second cochlear implant and the electrode array were successfully implanted into the cochlea. This article conducted a systematic review of the literature on electrode array misplacement, and the causes of electrode array misplacement were analyzed from different implantation position.
Subject(s)
Male , Humans , Child , Electrodes, Implanted , Reoperation , Cochlea , Cochlear Implantation , Cochlear Implants/adverse effects , Semicircular Canals/surgeryABSTRACT
This study compared long-term speech performance after cochlear implantation (CI) between surgical strategies in patients with chronic otitis media (COM). Thirty patients with available open-set sentence scores measured more than 2 yr postoperatively were included: 17 who received one-stage surgeries (One-stage group), and the other 13 underwent two-stage surgeries (Two-stage group). Preoperative inflammatory status, intraoperative procedures, postoperative outcomes were compared. Among 17 patients in One-stage group, 12 underwent CI accompanied with the eradication of inflammation; CI without eradicating inflammation was performed on 3 patients; 2 underwent CIs via the transcanal approach. Thirteen patients in Two-stage group received the complete eradication of inflammation as first-stage surgery, and CI was performed as second-stage surgery after a mean interval of 8.2 months. Additional control of inflammation was performed in 2 patients at second-stage surgery for cavity problem and cholesteatoma, respectively. There were 2 cases of electrode exposure as postoperative complication in the two-stage group; new electrode arrays were inserted and covered by local flaps. The open-set sentence scores of Two-stage group were not significantly higher than those of One-stage group at 1, 2, 3, and 5 yr postoperatively. Postoperative long-term speech performance is equivalent when either of two surgical strategies is used to treat appropriately selected candidates.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Cholesteatoma, Middle Ear/epidemiology , Chronic Disease/therapy , Cochlear Implantation/adverse effects , Cochlear Implants/adverse effects , Hearing Loss, Sensorineural/surgery , Inflammation/epidemiology , Otitis Media/surgery , Retrospective Studies , Speech Articulation Tests , Treatment OutcomeABSTRACT
Introducción: La cirugía de implante coclear, como cualquier otro acto quirúrgico, puede asociarse a complicaciones inherentes al procedimiento o por un fallo atribuible al dispositivo. Objetivo: Identificar y reportar la tasa de complicaciones asociadas a la implantación coclear en menores de 18 años atendidos en el programa de implante coclear en una institución en Bogotá, Colombia. Diseño: Estudio retrospectivo. Métodos: Se incluyeron pacientes a quienes se les realizaron implantes cocleares pediátricos en el período 1994 al 2011. Se analiza en este estudio a los que recibieron implante coclear a la edad de 18 años o menos. Desenlaces principales: tasa global de complicaciones; tasa discriminada de complicaciones por tipo: médico-quirúrgica, y complicaciones atribuibles a fallo del dispositivo. Resultados: Del total de implantes cocleares (920) realizados durante el período de estudio, se selecciona el grupo con edad ≤ 18 años a la fecha del implante, 598 (65%). Total complicaciones identificadas: 49 (8,2%). Complicaciones médico-quirúrgicas: 15 (2,5%). Fallos relacionados con el dispositivo: 5,7%. Conclusiones: La tasa global de complicaciones y fallos identificada en este estudio se asemeja a la reportada por diferentes estudios, la cual varía entre el 5 y el 13%
Introduction: Cochlear implant surgery, like any surgery, can be associated with complications inherent to the procedure or a failure attributable to the device. Objective: To identify and report the rate of complications associated with cochlear implantation in children under 18 years who presented to the cochlear implant program at a school in Bogota, Colombia. Design: Retrospective. Methods: Patients who underwent pediatric cochlear implants performed in the period 1994-2011. Is analyzed in this study who received cochlear implant at the age of 18 years or less. Main outcome measures: overall complication rate, rate of complications discriminated by type: medical-surgical complications due to device failure. Results: A total of cochlear implants (920) performed during the study period is selected age group ≤ 18 years at the time of implantation, 598 (65%). Total complications identified: 49 (8.2%). Medical-surgical complications: 15 (2.5%). Device-related failures: 5.7%. Conclusions: The overall rate of complications and failures identified in this study is similar to that reported by different studies, which varies between 5 and 13%
Subject(s)
Adolescent , Cochlear Implantation , Cochlear Implants/classification , Cochlear Implants/adverse effects , Cochlear Implants/history , Cochlear Implants/trends , Cochlear ImplantsABSTRACT
A técnica de acesso combinado (TAC) ao implante coclear (IC) é uma variação da técnica clássica de mastoidectomia e timpanotomia posterior (MPTA). A TAC combina um acesso transcanal à cocleostomia com uma timpanotomia posterior reduzida para a inserção dos eletrodos. OBJETIVO: Avaliar e comparar a segurança e efetividade em longo prazo alcançados com a TAC e MPTA em pacientes submetidos a IC em um centro brasileiro. Desenho científico: Estudo de série. MATERIAL E MÉTODO: Pacientes submetidos a IC usando TAC e MPTA foram acompanhados em um estudo de coorte. Os desfechos avaliados foram complicações, avaliação audiométrica e radiológica pós-operatórias. RESULTADOS: Quarenta e quatro pacientes foram implantados usando a TAC e 31 usando MPTA. Não houve casos de paralisia facial, mastoidite, colesteatoma ou fístula após 3,4±1,0 anos. A avaliação radiológica da posição dos eletrodos a mediana de eletrodos fora da cóclea foi de 0 no grupo TAC e de 3 no MPTA (p < 0,001). Não houve diferença entre os grupos em termos de desempenho audiológico no pós-operatório. CONCLUSÃO: A cocleostomia via transcanal combinada com uma timpanotomia posterior reduzida é um acesso alternativo ao IC que demonstrou segurança e menor migração de eletrodos em longo prazo. Esses achados encorajam o uso da via transcanal para a cocleostomia como uma opção alternativa de acesso ao IC.
The combined approach technique (CAT) is a variation of the classical the mastoidectomy-posterior tympanotomy technique (MPTA) that combines a transcanal approach to cochleostomy with a reduced posterior tympanotomy for insertion of electrodes. AIM: To compare and evaluate long-term safety and effectiveness outcomes obtained with the CAT and with MPTA approach in patients submitted to cochlear implant (CI) surgery. Design: series study. METHODS: Patients who underwent CI using CAT or MPTA at a Brazilian center were followed in a cohort study. Main outcomes were complications,audiometric performance and radiological evaluation of electrode position. RESULTS: Fourty-four patients were implanted using CAT and 31 MPTA. There were no cases of facial nerve paralysis, mastoiditis, cholesteatoma or cerebrospinal fluid leaks after 3.4±1.0 years. Radiological evaluation of electrode position revealed that the median number of electrodes outside the cochlea was 0 in CAT and 3 in MPTA groups (p < 0.001). There were no differences between both surgical approaches in terms of mean pure-tone thresholds with CI at all frequencies. CONCLUSION: Long-term follow-up data showed that the transcanal route to cochleostomy, combined with a reduced posterior tympanotomy, is a safe alternative approach in cochlear implant surgery, with no related major complications and fewer cases of electrode migration when compared with the MPTA. These findings encourage the use of the transcanal route to cochleostomy as an alternative approach option.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Cochlear Implants , Cochlea/surgery , Cochlear Implantation/methods , Cohort Studies , Cochlear Implantation/adverse effects , Cochlear Implants/adverse effectsABSTRACT
Cochlear implantations have become a routinely performed and successful surgical intervention in both adults and children. The current article reports the complications encountered in various age groups of consecutive children who underwent implantation in our center. We performed a prospective analysis of all profoundly deaf children who underwent cochlear implantation from March 2006 to July 2009 at Baqhiyatallah Cochlear Implantation Center. All patients were younger than 5 years old at the time of implantation. The minor complications occurred in 49 [18.7%] cases, The most common postoperative complications were temporary facial weakness detected in 15 cases [5.7%] all of which were reversible. Magnet wound was observed in 14 [5.3%] patients, keloid formation in 10 [3.8%], wound infection in 2 [0.8%], otitis media in 5 [2%], and electrode movement, meningitis, vertigo, Laryngospasm each in 1 [0.4%] case was detected among our patients. Cochlear implantation in children continues to be reliable and safe in experienced hands, with a low percentage of severe complications as long as the patient is monitored closely