A questionnaire was sent to 152 surgeons to survey complications associated with the implantation of the Nucleus multichannel cochlear implant. Complications were categorized as life-threatening; major, if they necessitated revision surgery; or minor, if they resolved spontaneously or with minimal treatment. A total of 55 complications occurred in 459 reported operations for an overall complication rate of 11.8%. There were no deaths, but there was one life-threatening complication, a case of meningitis. There were 23 (4.8%) major complications, most of which involved flap design or electrode insertion (and included the case of meningitis). There were 32 (7 %) minor complications. Most of the complications might have been avoided by proper training, planning of the operations, and careful attention to detail. We recommend that all prospective implant surgeons attend a device-specific training course and practice in the temporal bone laboratory.
Adult epiglottitis in patients with acquired immunodeficiency syndrome has not been previously reported. A pale, floppy epiglottis with supraglottic edema, cervical lymphadenopathy, a normal to low white blood count without a shift to the left, and rapidly progressive airway obstruction characterize this entity. In this small series of patients, conservative medical management was not successful, and aggressive airway intervention with appropriate intravenous antibiotic therapy was necessary.
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