Cochlear implantation in post-lingual adults

Abstract

Objectives: To demonstrate the efficacy of cochlear implants (CI) in post-lingual adults, including surgical and auditory outcomes based on a 25-year experience at a tertiary referral hospital. Methods:This study was a retrospective, descriptive chart review of post-lingual adults, aged ≥18 years, implanted at King Abdullah Ear Specialist Center (KAESC), Kingdom of Saudi Arabia (KSA), between September 1994 and March 2020. The study included 176 cochlear implantations performed in 144 patients. Data retrieval included patient demographics, clinical evaluation, operative details, postoperative course, and audiological evaluation parameters. The main outcome measures were surgical procedures, including techniques and complication rates, and audiological parameters as evaluated by pure tone audiometry average (PTA), speech reception threshold (SRT), and word recognition score (WRS). Student's t-test and Chi-square tests were used for statistical analysis and a p-value<0.05 was considered significant.Results: Pure tone audiometry average, SRT, and WRS improved significantly after CI. Overall, major complications occurred in 3 patients. One patient underwent CI ex-planation for severe pain, and 2 had device malfunctioning. Other minor complaints were reported in 18% of the patients. Conclusion:Cochlear implants performed, in our institute, on post-lingual adults resulted in significant improvements in auditory performance, including PTA, SRT, and WRS values with low complication rates.

Incidence of Cochlear Implantation Complications in Saudi Arabia: A Comprehensive Systematic Review of the Literature

“…Of the included studies, 10 were retrospective [5][6][7][8][9][10][11][12][13][14], one was a cross-sectional study [15], three were case series [16][17][18], and three were case reports [19][20][21]. All studies were conducted in Saudi Arabia.…”

“…Surgical difficulties were reported in six patients (0.26%), either due to resistance to inserting an electrode due to causes such as intracochlear fibrosis, or due to other factors such as weakness of the posterior canal, injury to the auditory canal, and pain that required conversion to general anesthesia. Aljazeeri et al reported that dura accidental exposure and bleeding occurred in a total of three patients (0.13%) [ 5 ]. Aljazeeri et al also reported accidental facial nerve exposure in one case [ 5 ].…”

“…Aljazeeri et al reported that dura accidental exposure and bleeding occurred in a total of three patients (0.13%) [ 5 ]. Aljazeeri et al also reported accidental facial nerve exposure in one case [ 5 ]. No major intraoperative complications associated with CIs have been reported.…”

“…Ensuring that patients who undergo CI receive vaccination against Streptococcus pneumoniae since it is the most common organism causing meningitis in CI patients, which is due to accidental dura exposure. Maintaining a sterile surgical field and instruments, having an experienced surgeon perform the operation, and attending to the wound postoperatively ensure proper management of this complication [ 5 ]. Additionally, bleeding can also occur and is managed intraoperatively by identifying bleeding areas and controlling them by inserting a bleeding drainage plug, followed by pressure dressings to safely ensure the stoppage of the bleed [ 27 ].…”