Delayed-onset swelling around the implant after cochlear implantation: a series of 26 patients

Shu, Fan; Minyun, Yao; Liu, Yimeng; Cai, Jieqing; Xu, Muqing; Jiang, Shanshan; Tan, Xiao; Tang, Jie; Zhang, Hongzheng

doi:10.1007/s00405-022-07537-x

Cited by 4 publications

(10 citation statements)

References 37 publications

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“…Personal communications with other cochlear departments in the UK have revealed at least two other children in different units with a similar pattern of recurrent swellings, who were implanted with Cochlear devices. Shu et al (9) found 5 of their 26 cases to have Medel implants, with 16 having Cochlear devices, and 5 having Advanced Bionics devices. None of their five cases with recurrent swellings had Medel devices.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent Swelling in Pediatric Cochlear Implant Patients

Shaida

Magos²,

Kanona³

et al. 2023

Otol Neurotol

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ObjectiveTo determine the prevalence, characteristics, and outcomes of pediatric patients with recurrent swelling over their cochlear implant receiver package.Study DesignRetrospective case review.SettingTertiary referral center.PatientsA total of 332 bilateral cochlear implant patients under the age of 18 years were reviewed. Twelve patients with more than one episode of swelling around their cochlear implant receiver package were isolated. Patients with clinical evidence of infection were excluded from the study. The etiology of hearing loss was heterogeneous.InterventionThree patients underwent ultrasound, and three patients underwent bedside aspiration. Most patients were treated with 7 days of oral broad-spectrum antibiotics.Main Outcome MeasureIncidence, frequency, and course of recurrent swelling around cochlear implant receiver packages.ResultsThe first swelling appeared between 0.86 and 9.95 years after surgery (mean, 3.38), and the occurrence of the last episode ranged from 0.06 to 3.42 years from the current date (mean, 1.04). The total number of episodes ranged from 2 to 18 (mean, 6). Seven patients had unilateral swellings, and five had bilateral swellings. Swellings were associated with upper respiratory tract infection or minor trauma, or had no identifiable cause. Aspiration in three cases showed evidence of altered blood.ConclusionsRecurrent otherwise asymptomatic swelling over cochlear implant receiver packages in children is more common than initially thought. Possible causes include hematoma and seroma secondary to upper respiratory tract infection. The incidence and the timing of swelling are variable. There were no swelling-related device failures or reimplantations so patients and parents can be reassured about the long-term outcome.

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Section: Discussionmentioning

confidence: 99%

“…Shu et al (9) recently reported on a series of 26 pediatric patients with delayed onset swelling around the receiver–stimulator package, with onset of swelling ranging from 4 to 178 months after implantation. This was out of a total of 1,425 patients implanted over a 19-year period, a rate of 1.8%.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Swelling in Pediatric Cochlear Implant Patients

Shaida

Magos²,

Kanona³

et al. 2023

Otol Neurotol

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“…Thus, while many cases can improve with conservative treatment, some may require implant removal. Some reports have recommended needle aspiration as treatment (8)(9)(10); however, we do not perform this procedure owing to the risk of introducing infection (10,11).…”

Section: Discussionmentioning

confidence: 99%

“…A previous report has described cases of multiple swelling recurrences (8). Our findings revealed that while recurrent swelling occurred in approximately 20% of cases, all cases improved with conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, a posterior S-shaped incision was made in most patients. The skin incision type is reportedly unrelated to the occurrence of flap issues (8,9). Most cases of swelling in this study followed implantation with MED-EL devices; however, there are no obvious differences among the various implant devices regarding the incidence of swelling (8,9).…”

Section: Discussionmentioning

confidence: 99%

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Temporal Swelling Following Cochlear Implantation: Frequency, Treatment, and Outcomes

Kasuga,

Yoshimura,

Takumi

2024

Otol Neurotol

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Objective To investigate the frequency, treatment, and outcomes of postoperative delayed-onset swelling around cochlear implants. Study Design Retrospective, observational, nonrandomized group study. Setting Academic medical center. Patients/Interventions Among 354 patients (516 ears) who underwent cochlear implantation (CI) at our hospital between May 2009 and October 2022, 329 (472 ears: 138 children [246 ears] and 191 adults [226 ears]) with a follow-up period of >3 months were included. Main Outcome Measures Physical examination and computed tomography of the head were performed. Results In total, 5.5% (26/472 ears) had a history of delayed-onset swelling around the implant. This complication occurred in 9.8% (24/246 ears) of children and 0.9% (2/226 ears) of adults. The mean time to onset of swelling was 50 (range, 5.5–147) months following CI. In 60% (21/35) of the cases, the cause was unknown, whereas in 25.7% (9/35) and 11.5% (4/35) of cases, it was head trauma and acute inflammation, respectively. Conservative treatment (observation, antibiotics, and/or strong magnetic compression) was adapted in 91.4% (32/35) of cases. After conservative treatment, revision CI surgery was performed in one ear. Additionally, recurrent swelling was observed in 23.1% (6/26 ears) of swelling cases. Conclusions The results suggest that delayed-onset swelling around implants occurs more frequently in children than in adults because of the higher incidence rates of head trauma and acute otitis media in children. In most cases, conservative treatment was adequate; however, careful follow-up is necessary. Our findings can serve as a reference for optimizing care and intervention options after CI.

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Cochlear Implant Infections

O’Leary,

Choong

2024

Infections of the Ears, Nose, Throat, and Sinuses

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Delayed-onset swelling around the implant after cochlear implantation: a series of 26 patients

Cited by 4 publications

References 37 publications

Recurrent Swelling in Pediatric Cochlear Implant Patients

Recurrent Swelling in Pediatric Cochlear Implant Patients

Temporal Swelling Following Cochlear Implantation: Frequency, Treatment, and Outcomes

Cochlear Implant Infections

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