A Study of Complications and Morbidity Profile in Cochlear Implantation: The MERF Experience

Abstract

Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe to profound hearing loss. This is a safe and standard procedure in the hands of experienced implant surgeons. Complications due to surgery are minimal and are often encountered in cases with congenital anomalies of the temporal bone and inner ear. Complications in CI are related to malfunctioning of the device or the process of wound healing. In most cochlear implant centers, as the surgeon's skill and clinical expertise in managing various cochlear implant cases improves with years of experience, the complication rates in his series ideally come down over time. Over the years, these well experienced clinics become tertiary referral centers for CI, receiving many difficult cases for implantation and hence such centers report data on complications, which become an important reference for many aspiring implant surgeons. Our study, performed in a premier CI centre in Chennai, looks at the various complications which were encountered in a case series of 300 implantees. Retrospective descriptive study with data collected from operative notes, patient questionnaires, auditory habilitation registers and medical records of cochlear implantees operated between, November 2006 to November 2010. A spectrum of major and minor complications, were categorized. Their incidence rates in relation to the demography of the patient profile and various events during surgical procedure were documented and analyzed.Appropriate management protocols were defined. Our management protocols have been highlighted and the relevant literature reviewed. This report of our experience with 300 cochlear implantees, reveals that complication rates at our center are in comparison with reputed centers worldwide. CI is very safe in the long term and provides optimal auditory awareness with speech perception and intelligibility for profoundly deaf individuals giving them an avid opportunity to integrate within the normal society.

After cochlear implantation: Complications related to flap around implants

“…The most common complications of cochlear implantation are: flap necrosis, infection, rupture and resultant device explantation ( Trinidade et al., 2008 ). In our study, the rate of complications related to flap around implants was 3.7%, while rates of complications reported in the literature range from 0.06% to 10% ( Raghunandhan et al., 2014 , Ajallouyean et al., 2011 , Cunningham et al., 2004 , Rubienstein et al., 1999 , Hopfenspirger et al., 2007 , Cohen and Hoffman, 1991 , Kempf et al., 1999 ).…”

Non-mastoidectomy Cochlear Implant Approaches: A Literature Review

“…This study also reveals that electrode fixation was not a matter of concern in the techniques analyzed, given that the rate of electrode extrusion in over 1000 patients was 0.79% in SMA and 1.88% for the transcanal approach. Junior et al 8 reported one case (0.4%) of electrode exclusion out of 250 cases that underwent CI by the PA approach, and Raghunandhan et al 30 reported another single case (0.3%), out of 300 cases that underwent CI by the PT approach.…”

Complications of post-cochlear implantation in 1027 adults and children

“…Early postoperative complications are wound infection, skin necrosis, facial paralysis, seroma, vertigo, meningitis and tinnitus. One of the potentially critical complications of CI is meningitis and precautions should be taken in all cases, especially if a cerebrospinal gusher occurs after opening the cochlea 7. Late postoperative complications include failure of the device, facial nerve twitching on stimulation and chronic ear infection with or without cholesteatoma.…”