Surgical findings and auditory performance after cochlear implant revision surgery

Manrique-Huarte, Raquel; Huarte, Alicia; Manrique, Manuel Jesús González

doi:10.1007/s00405-015-3610-0

Cited by 32 publications

(41 citation statements)

References 25 publications

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“…When pooled, these studies accounted for 21,301 cochlear implants, 1,277 reimplants, and an overall reimplantation rate of 6.0% (range, 0.47%-6.87%) (Table V). 4,5,[8][9][10][11][12][13][14][15]17,18,[20][21][22][23][24][25][26][27][28][29] Studies ranged in the duration of data collection from 7 to 30 years and ranged in primary implant numbers from 212 to 3,417. The pooled medical failure rate was 2.1%, and the device failure rate was 3.6%.…”

Section: Resultsmentioning

confidence: 99%

Cochlear implant failures and reimplantation: A 30‐year analysis and literature review

et al. 2019

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Objectives/Hypothesis The objectives of the study were to present an institutional experience with device failures and cochlear reimplantation rates over a 30‐year period and to perform a detailed literature review. Study Design Retrospective institutional experience and literature review. Methods A review of cochlear implant failures over a period of 30 years, between January 1988 and March 2017, at a single institution was conducted. Cochlear implant failures were calculated based on manufacturer, type of failure, and overall failure rate. Survival analysis was performed using Kaplan‐Meier curves. An electronic search of the PubMed, Web of Science, and EMBASE databases revealed 24 articles on the topic of cochlear device failure. Data on reimplantation and device failure rates were extracted from this literature review and analyzed. Results A total of 804 cochlear implantations were reviewed from three manufacturers. The institutional reimplantation rate was 2.9% compared to the pooled rate of 6.0% calculated from the literature review. Medical failures accounted for 0.5% of the overall failures, device failures accounted for 1.6%, and inconclusive failures account for 0.7%. Survival analysis revealed a significant difference among manufacturers. An improved device failure rate was noted in the adult population (0.8%) as compared to the pediatric population (2.8%). Conclusions This 30‐year review represents one of the longest series in the literature examining reimplantation, device failure, and medical failure rates. Cochlear implant survival varied by manufacturer and was significantly better in adult compared to pediatric patients. Level of Evidence NA Laryngoscope, 130:782–789, 2020

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Section: Resultsmentioning

confidence: 99%

Cochlear implant failures and reimplantation: A 30‐year analysis and literature review

et al. 2019

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“…In contrast to the surgically oriented reports, there is a paucity of studies that examine functional outcomes of reimplantation surgery. In a recent study by Manrique-Huarte, Huarte, & Manrique (2016) , of 962 pediatric and adult patients implanted over a 23-year period, 38 patients required reimplantation (28 children, 10 adults). The authors report that aided pure-tone hearing thresholds improved in 44% of the reimplanted patients, with 11% showing no change in their thresholds.…”

Section: Introductionmentioning

confidence: 99%

Speech Recognition Outcomes After Cochlear Reimplantation Surgery

et al. 2017

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This study compares speech recognition outcomes before and after cochlear reimplantation surgery, in relation to clinical factors known before and at time of surgery. Between 2006 and 2015, 2,055 adult cochlear implant surgeries were conducted at this center, of which 87 were reimplantation surgeries (4.2%). Speech recognition scores (SRS) assessed before and after reimplantation were available for 54 adults. Overall, SRS measured after reimplantation were similar to the best SRS obtained by the patient and greater than the last SRS measured before surgery. Additional complications were noted in the clinical files of all patients for which reimplantation was considered unsuccessful (16%).

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“…Electrode migration or partial insertion during the first surgery could be the causes of no improvement in speech perception [10]. After the revision surgery, it could be confirmed that the electrode did not migrate outside the cochlea and that it was fully inserted (first white marker was seen in the round window).…”

Section: Discussionmentioning

confidence: 97%

“…Following this concept, an electrode afterload seems attractive and logical when hearing loss progresses and greater insertion depths are required for better outcomes. Also, in the case of postoperative hearing loss, the electrode can be further inserted, so the patients can benefit from greater cochlear coverage using electric stimulation only [10].…”

Section: Discussionmentioning

confidence: 99%

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Electrode Afterload: A Valuable Technique in a Case of Short Electrode Insertion

Riemann

Scholz²,

Sudhoff

et al. 2020

Case Reports in Otolaryngology

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Introduction. The location of the electrode inside the cochlea is important for speech performance. However, many variables, including array length, insertion depth, and individual anatomy, may affect the intracochlear position of the electrode. Insertion deeper than 20 mm and revision surgery are critical situations in which residual hearing and electrode integrity may be at risk. This case report challenges this hypothesis and raises the following question: is it possible to achieve a better speech understanding with an electrode afterload without compromising residual hearing? Case Report. A 73-year-old female patient showed up for evaluation of hearing loss. The patient was operated four times in an external hospital due to cholesteatoma formation in the right ear. Related to a poor aided speech understanding, a CI-surgery was performed. 5 months after the surgery, the subject returned with poor speech understanding. A revision surgery was performed, where the first white marker of the electrode was seen in the round window (20 mm). The electrode was inserted 4 mm deeper into the cochlea. After six and twelve months, the results of the Freiburger monosyllabic speech test improved till 25% and 45%, respectively. Discussion. Hearing preservation is possible with a revisional deeper insertion from 20 mm to 24 mm. In this case, a partial obliteration of an open cavity made the electrode surgically easily accessible. This allowed the deeper insertion during the revision surgery. In a regular surgical field with a posterior tympanotomy, the revision surgery is more challenging and brings the electrode into the risk of an iatrogenic destruction. Conclusion. This case of an electrode afterload after having inserted the electrode initially to mm, demonstrates that hearing can be preserved and speech perception can improve after performing this maneuver.

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Surgical findings and auditory performance after cochlear implant revision surgery

Cited by 32 publications

References 25 publications

Cochlear implant failures and reimplantation: A 30‐year analysis and literature review

Cochlear implant failures and reimplantation: A 30‐year analysis and literature review

Speech Recognition Outcomes After Cochlear Reimplantation Surgery

Electrode Afterload: A Valuable Technique in a Case of Short Electrode Insertion

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