Cochlear Implantation in China: Review of 1,237 Cases with an Emphasis on Complications

Abstract

Objective: The purpose of this study is to retrospectively review the complications of patients who underwent cochlear implantation at 51 hospitals in mainland China over a decade. Methods: A retrospective analysis of 1,237 patients who underwent cochlear implantation from February 1998 to December 2008. The patients were reviewed for demographic information, type of hearing loss, abnormal findings on temporal CT scans, cochlear implant device, procedure time, and complications that included meningitis, hematoma (intracranial and extracranial), wound infection and implant extrusion, cerebrospinal fluid leak and facial palsy. Results: A total of 1,237 patient records were identified, and pertinent clinical information was reviewed. Of the patients, 59.6% were male, and 98.9% were prelingually deaf. The most common etiologies of hearing loss were: ototoxicity (28.1%), non-syndromic congenital hearing loss (14.8%), and inner ear malformation (18.5%). Inner ear malformations included: enlarged vestibular aqueduct (9.4%), Mondini defect (5.4%), common cavity (2.8%), cochlear ossification (3.9%), round window dysplasia (0.4%), and narrow internal auditory meatus (1.2%). The most common intraoperative complications were: gusher (5%) and electrode kinking (2.3%). The most common postoperative complications were hematoma (1.7%), wound infection and implant extrusion (0.5%), and device failure (0.9%). No CSF leakage or permanent facial palsy occurred. Conclusions: Cochlear implantation is a safe and reliable otosurgical procedure in China, and the rate of complications is similar to developed countries. Carefully preoperative preparation and standardization of the procedure are important for the development of cochlear implant programs in developing countries.

CSF Gusher in Cochlear Implant Surgery–does it affect surgical outcomes?

“…The incidence of cerebrospinal fluid (CSF) gusher in cochlear implantation is reported between 1 and 5% in many series [2,12,13]. Papsin reported that gusher was present in 6.7 per cent of 103 patients with malformations [6].…”

“…Major complications reported are CSF leakage, skin necrosis, postoperative meningitis, facial nerve damage, hemorrhage and device failure needing explanation [2,3]. These complications are reported to be more frequent in cases with congenital anomalies like common cavity, incomplete partition deformity and large vestibular aqueduct syndrome [4].…”

Hearing Restoration for Adults with Vestibular Schwannoma in the Only Hearing Ear: Ipsilateral or Contralateral Cochlear Implantation?

“…In our study, all 3 patients had bilateral severe to profound hearing loss, and little or insufficient improvement with conventional hearing aids. In such circumstances, CI is the first choice, considering that it is relatively easy to perform, with little difficulty in achieving correct placement of the prosthesis and with negligible risk to patients [11]. …”

Complicações em 550 cirurgias consecutivas de implante coclear

“…Although the prevalence of complications in our sample is higher than those from most studies in the literature, we believe this can be explained by the fact that we operate cases of higher complexity, with cochlear ossification and inner ear malformation [8][9][10][11][12][13][14][15][16] . Moreover, our clinic is a center for the training of ear surgeons, with a complementary specialization program, in which trainee surgeons participate actively in the cochlear implant surgeries.…”