The French Cochlear Implant Registry (EPIIC): Cochlear implantation complications

Parent, V.; Codet, Maxime; Aubry, Karine; Bordure, Philippe; Bozorg-Grayeli, Alexis; Déguine, Olivier; Eyermann, C.; Franco-Vidal, V.; Guevara, N.; Karkas, Alexandre; Klopp, Norman; Labrousse, M.; Lebreton, J.-P.; Lerosey, Y.; Lescanne, E.; Loundon, Natalie; Marianowski, R.; Merklen, F P; Mezouaghi, K.; Mom, T.; Moreau, S.; Mosnier, Isabelle; Noël-Pétroff, N.; Parietti‐Winkler, Cécile; Piller, P.; Poncet, C.; Radafy, E.; Roman, S.; Roux-Vaillard, S.; Schmerber, S.; Tavernier, L; Truy, Éric; Vincent, C.; Godey, Benoît

doi:10.1016/j.anorl.2020.07.007

Cited by 16 publications

(9 citation statements)

References 38 publications

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“…Major complications requiring revision surgery occurred in 3 out of 65 ears, which translates to a rate of 4.6%. While this appears relatively high, it is comparable to literature reports and somewhat explainable looking into detail of the cause of complications [ 54 , 55 ]. For example, a head injury leading to electrode short-circuit or electrode dysfunction and the third case of wound dehiscence 2 days after surgery might not be directly related to the device rather than to poor wound healing.…”

Section: Discussionsupporting

confidence: 85%

Long-Term Device Satisfaction and Safety after Cochlear Implantation in Children

Urík

Šikolová

Hošnová

et al. 2022

JPM

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(1) Objectives: For full benefit in children implanted with a cochlear implant (CI), wearing the device all waking hours is necessary. This study focuses on the relationship between daily use and audiological outcomes, with the hypothesis that frequent daily device use coincides with high device satisfaction resulting in better functional gain (FG). Confounding factors such as implantation age, device experience and type of device were considered. (2) Results: Thirty-eight CI children (65 ears) were investigated. In total, 76.92% of the children were using their device for >12 h per day (h/d), 18.46% for 9–12 h/d, the remaining for 6–9 h/d and one subject reported 3 h/d. The revision rate up to the 90-month follow-up (F/U) was 4.6%. The mean FG was 59.00 ± 7.67 dB. The Audio Processor Satisfaction Questionnaire (APSQ) separated for single unit (SU) versus behind the ear (BTE) devices showed significantly better results for the latter in terms of wearing comfort (WC) (p = 0.00062). A correlation between device use and FG was found with a device experience of <2 years (n = 29; r2 = 0.398), whereas no correlation was seen with ≥2 years of device experience (n = 36; r2 = 0.0038). (3) Conclusion: This study found significant relationships between daily device use and FG, wearing comfort and long-term safety (90 months).

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Section: Discussionsupporting

confidence: 85%

Long-Term Device Satisfaction and Safety after Cochlear Implantation in Children

Urík

Šikolová

Hošnová

et al. 2022

JPM

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“…In Parent et al, patients with cochlear malformations suffered from an increased rate of statistically significant complications. Multivariate analysis found that adult patients with cochlear malformations had a higher rate of complications than pediatric patients [25]. The combined minor and major complication rate was 10.12% (6.4%-15.6%) in patients suffering from cochlear malformations; however, the type of complication was not stratified by etiology of deafness [25].…”

Section: Operative Findingsmentioning

confidence: 87%

Systematic review of cochlear implantation in patients with inner ear malformations

Shah

Walters²,

Langlie³

et al. 2022

PLoS ONE

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Objectives To evaluate the outcomes of cochlear implantation in patients with severe to profound sensorineural hearing loss due to inner ear malformations (IEMs) when compared to patients without IEMs. We discussed audiological outcomes such as open-set testing, closed-set testing, CAP score, and SIR score as well as postoperative outcomes such as cerebrospinal fluid gusher and incomplete insertion rate associated with cochlear implantation in individuals with IEMs. Data sources PubMed, Science Direct, Web of Science, Scopus, and EMBASE databases. Review methods After screening a total of 222 studies, twelve eligible original articles were included in the review to analyze the speech and hearing outcomes of implanted patients with IEMs. Five reviewers independently screened, selected, and extracted data. The “Tool to Assess Risk of Bias in Cohort Studies” published by the CLARITY group was used to perform quality assessment on eligible studies. Systematic review registration number: CRD42021237489. Results IEMs are more likely to be associated with abnormal position of the facial nerve, raising the risk of intraoperative complications. These patients may benefit from cochlear implantation, but audiological outcomes may also be less favorable than in individuals without IEMs. Furthermore, due to the risk of cerebrospinal fluid gusher, incomplete insertion of electrodes, and postoperative facial nerve stimulation, surgeons can employ precautionary measures such as preoperative imaging and proper counseling. Postoperative imaging is suggested to be beneficial in ensuring proper electrode placement. Conclusions Cochlear implants (CIs) have the potential to provide auditory rehabilitation to individuals with IEMs. Precise classification of the malformation, preoperative imaging and anatomical mapping, appropriate electrode selection, intra-operative techniques, and postoperative imaging are recommended in this population.

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“…The complication rates in this analysis are similar to other recently published studies with large cohorts. A retrospective analysis of the French Cochlear Implant Registry by Parent et al (19) evaluated 3,483 adults and found a complication rate of 6.2%, with no significant relationship between age and complication rates. Their study, however, categorized complications by local, device-related, cochleovestibular, and lesions of adjacent structures and did not account for systemic complications that are important to consider given the need for general anesthesia during CI surgery.…”

Section: Discussionmentioning

confidence: 99%

Association of Baseline Frailty Status and Age With Postoperative Complications After Cochlear Implantation: A National Inpatient Sample Study

et al. 2022

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ObjectiveTo conduct a national registry-based evaluation of the independent associations of chronological age and frailty, as measured by 5- and 11-factor modified frailty index (mFI-5, mFI-11) score, on postoperative outcomes of participants undergoing cochlear implantation (CI).Study DesignCross-sectional analysis.SettingMulticenter national database.ParticipantsAdults 18 years or older who underwent CI during 2001 to 2018.Main Outcome MeasuresAny postoperative complications (determined as the presence of major, minor, or implant-specific), extended hospital length of stay (eLOS) (≥75th percentile of study population), and nonhome discharge destination.ResultsThere were 5,130 participants included with a median age of 60 years (interquartile range, 44–73 y) and slight female predominance (53.5%). Under mFI-5 scoring, there were 2,979 (58.1%) robust (mFI-5 = 0), 1710 (33.3%) prefrail (mFI-5 = 1), 362 (7.1%) frail (mFI-5 = 2), and 78 (1.5%) severely frail (mFI-5 ≥ 3) participants. Three hundred twenty-eight (6.49%) participants experienced a postoperative complication, with 320 (6.2%) discharged to a nonhome destination. Multivariate analysis showed no statistically significant correlation between increasing participant age or frailty status and postoperative complications; however, increasing baseline frailty tier showed an independent association with risk of eLOS (severely frail: odds ratio, 4..83; 95% confidence interval, 3.00–7.75; p < 0.001) and nonhome discharge (severely frail: odds ratio, 6.51; 95% confidence interval, 3.81–11.11; p < 0.001). The mFI-11 showed very similar trends.ConclusionAmong those evaluated, this study demonstrates that CI is a low-risk procedure in participants of all ages. Increasing frailty does not predispose to postoperative complications. However, frail patients are at additional risk for an eLOS and nonhome discharge. Short follow-up time, hospital-coding errors, and selection bias of more robust patients may limit the true results of this study.

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The French Cochlear Implant Registry (EPIIC): Cochlear implantation complications

Cited by 16 publications

References 38 publications

Long-Term Device Satisfaction and Safety after Cochlear Implantation in Children

Long-Term Device Satisfaction and Safety after Cochlear Implantation in Children

Systematic review of cochlear implantation in patients with inner ear malformations

Association of Baseline Frailty Status and Age With Postoperative Complications After Cochlear Implantation: A National Inpatient Sample Study

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