Pain-only complaint about cochlear implant device: A five-patient pediatric experience

Abstract

Pain may be the sole clinical manifestation of cochlear implant device failure. We offer a flowchart for the care of CI patients with pain, encourage a worldwide registry of such cases, and offer ideas to try to understand better the problem.

Pain at the Cochlear Implant Site Requiring Device Removal in Pediatric Patients

“…Prior studies included 4, 5, or 10 device explantations. [4][5][6] Our results confirm a previous observation that this complication occurs most commonly in females several years after device implantation. 6 Importantly, we observed that idiopathic pain with bacterial device-site infection most often occurred after sequential cochlear implantation.…”

“…This idiopathic persistent CI pain may severely limit use of the device and may necessitate revision surgery despite not elucidating the cause for pain. [4][5][6] Prior studies of persistent CI pain have reported a prevalence rate ranging from 0.86% to 2.8% of implanted patients. [4][5][6] This pain often presents in a delayed timeframe postoperatively, with a mean of 5.8 years in one study.…”

“…[4][5][6] Prior studies of persistent CI pain have reported a prevalence rate ranging from 0.86% to 2.8% of implanted patients. [4][5][6] This pain often presents in a delayed timeframe postoperatively, with a mean of 5.8 years in one study. 4 Vijendren et al recently proposed three possible causes for pain at the CI site: 1) biofilm of the device causing localized inflammation, 2) neurogenic pain, and 3) psychogenic pain.…”

“…A high rate of explantation has been reported among patients with persistent pain after CI, ranging from 20% to 100%. [4][5][6] Explantation carries the potential for poorer audiological performance after reimplantation, 15 although recent studies have shown that results are typically favorable. 2,13,[16][17][18] In children, revision surgery can be particularly challenging due to bony regrowth and altered anatomy from prior surgery.…”

A Case Report of Delayed Onset Spontaneous Hematoma, Pain, and Temporal Bone Neo-Ossification 16 Years After Cochlear Implantation

“…Subsequent reimplantation was uneventful and no reason for initial pain onset could be identified. 6 There have been studies published mentioning neo-ossification that was found in revision surgery, but this was related to the ossification of the cochlea and the mastoid cavity. 7 One study found that intracochlear osseous tissue was more present in cases where the electrode was folded, though that was not the case in our patient.…”