Latin American experience with the cochlear implant.

CONCLUSIONS: Complications such as migration, extrusion, skin inflammation by magnets and implant failures are mostly related to the type of device. Meticulous technique rather than specific surgical approaches seems to be the key in avoiding complications. The overall results of the Latin American experience are comparable with those reported recently in the literature. OBJECTIVE: To review the experience of Latin American groups with the cochlear implant. MATERIAL AND METHODS: A questionnaire was sent to all cochlear implant teams in Latin America. The main questions involved: (i) the type of device; (ii) the techniques used for placing and fixing the implant, surgical incision and closure; (iii) migration, exposure and failure of the implant; and (iv) skin erosion and infection. A total of 41 groups participated in the study. The total number of implanted patients involved was 3773, representing 92% of Latin American cases. RESULTS: Of the 3773 devices implanted, 5 were experimental prototypes and therefore 3768 were considered for calculations. The occurrence of complications was as follows. Migration: 13 cases (0.35%), mostly related to ceramic implants (p =0.016). Extrusion: 15 cases (0.4%), mostly related to large implants (p =0.0103). Implant failure secondary to trauma: 18 cases (0.48%) (9 in ceramic and 9 in soft implants). Spontaneous failure: 86 cases (2.28%), 74/1293 (5.72%) in ceramic and 11/2418 (0.45%) in soft implants (p = 0.0001). The most reliable implant was the Nucleus 24, with a failure rate of 0.3%. Skin inflammation by magnet: 35 cases (0.9%), mostly related to soft implants (p =0.0103). INFECTION: 26 cases (0.7%), with no significant relationship to device type.