Cochlear Implants International[JOURNAL]
Sun
200 papers
Delayed-onset facial paralysis following cochlear implantation: a case study and comprehensive analysis.
Gülüstan F, Yazıcı ZM, Koç RH … +3 more , İnan BK, Aşaroğlu CB, Sayın İ
Cochlear Implants Int · 2024 Jul · PMID 38970817 · Publisher ↗
OBJECTIVES: Cochlear implantation (CI) is a surgical intervention used to rehabilitate hearing in individuals, both pediatric and adult, with severe hearing loss. It is generally a safe procedure with rare postoperative...
OBJECTIVES: Cochlear implantation (CI) is a surgical intervention used to rehabilitate hearing in individuals, both pediatric and adult, with severe hearing loss. It is generally a safe procedure with rare postoperative complications. Facial nerve paralysis following cochlear implant surgery poses challenges in diagnosis and treatment. METHODS: This case report details a 48-year-old male who experienced delayed facial paralysis after cochlear implantation, an uncommon occurrence with limited documentation. RESULTS: The facial nerve palsy of the patient resolved by the third week with combined therapy. DISCUSSION: The etiology of this complication is not fully understood, with latent virus reactivation, particularly HSV and VZV, hypothesized as a probable cause. CONCLUSION: Successful management involves a combination of corticosteroids, antiviral therapy, and antibiotics, leading to a favorable outcome.
Utilization of SmartNav technology in cochlear implantation: optimizing efficiency in assessment of electrode placement.
Cooper J, Stidham KR, Morgan S … +2 more , Schmelzer M, Albinus R
Cochlear Implants Int · 2024 Jul · PMID 38958389 · Publisher ↗
OBJECTIVES: Proper electrode placement is essential for favorable hearing outcomes following cochlear implantation. Though often used, traditional intraoperative X-ray imaging is time consuming, exposes patients and staf...
OBJECTIVES: Proper electrode placement is essential for favorable hearing outcomes following cochlear implantation. Though often used, traditional intraoperative X-ray imaging is time consuming, exposes patients and staff to radiation, and poses interpretational challenges. The Nucleus® SmartNav System, utilizes electrode voltage telemetry (EVT) to analyze the positioning of the electrode array intraoperatively. This study investigates the efficacy of SmartNav in optimizing the efficiency and accuracy of assessing electrode placement. METHODS: This prospective clinical study analyzed placement of 50 consecutive Cochlear Corporation cochlear implants conducted at a single institution between March of 2022 and June of 2023. Placement check of electrode array using SmartNav and X-ray was completed and individually assessed. A comparative analysis of SmartNav and X-ray completion times for electrode placement assessment was conducted. RESULTS: Subjects included nine ears with abnormal anatomy and three reimplants. SmartNav placement check required a total time of 2.12 min compared to X-ray imaging at 14.23 min ( = 1.6E-16, CI 95%). Both SmartNav and X-ray had excellent sensitivity of 100% in identifying appropriate electrode position ( = 1.0). Tip fold-over was identified using both modalities in 3 cases with noted easier interpretation using SmartNav. CONCLUSION: The Nucleus® SmartNav System significantly outperformed traditional X-ray imaging, offering a faster and more straightforward approach to assessing electrode positioning during cochlear implant surgery, thereby enhancing surgical efficiency and patient safety.
Worldwide differences in surgeon intraoperative practices for cochlear implantation.
Jiam NT, Podury A, Quesnel AM … +1 more , Handzel O
Cochlear Implants Int · 2024 Sep · PMID 38935802 · Publisher ↗
OBJECTIVE: To characterize practice patterns of intraoperative imaging and/or functional confirmation of cochlear implant electrode location worldwide. METHODS: A cross-sectional survey of otolaryngologists performing co...
OBJECTIVE: To characterize practice patterns of intraoperative imaging and/or functional confirmation of cochlear implant electrode location worldwide. METHODS: A cross-sectional survey of otolaryngologists performing cochlear implantation was conducted between March 1 and May 6, 2023. Participants were recruited worldwide using an international otologic society membership email list and at professional meetings. Ninety-seven of the 125 invited participants (78%) completed the survey. Participants were categorized by continent. RESULTS: North American surgeons use intraoperative X-rays more frequently than surgeons in Europe and Asia ( < 0.001). Otolaryngologists in Europe and Asia more frequently use no intraoperative imaging ( = 0.02). There is no regional difference between the intraoperative use of electrophysiologic instruments. European and Asian surgeons implant MED-EL devices ( = 0.012) more frequently than North American surgeons, who more frequently use Cochlear Corporation devices ( = 0.003). MED-EL use is related to less frequent intraoperative X-ray use ( = 0.02). Advanced Bionics use is related to more frequent intraoperative CT use ( = 0.03). No significant association existed between years of practice, number of cochlear implantation surgeries performed yearly, volume of pediatric CI practice, and use of intraoperative tools. CONCLUSION: Intraoperative practice for radiologic and functional verification of cochlear implant electrode positioning varies worldwide. Practice guidelines may help establish a standard of care for cochlear implantation.
Importance of preoperative HRCT temporal bone in the orientation of the cochlea and its relation to intra-operative difficulties in cochlear implantation - predicting the grades of difficulty.
Suri N, Sharma D
Cochlear Implants Int · 2024 May · PMID 38812414 · Publisher ↗
OBJECTIVE: This study emphasizes the role of preoperative high-resolution computed tomography (HRCT) temporal bone in evaluating the variation in cochlear orientation and proposes a grading system to determine the level...
OBJECTIVE: This study emphasizes the role of preoperative high-resolution computed tomography (HRCT) temporal bone in evaluating the variation in cochlear orientation and proposes a grading system to determine the level of intraoperative difficulties encountered. METHODS: Preoperative correlation of middle ear and inner ear structures along with the basal turn angle (BTA) was done to assess the orientation. Patients were divided into three groups depending on BTA and radiology findings. RESULTS: Group A (BTA = 55°-60°) had statistically significant ( < 0.05) correlation between middle ear to inner ear structures on HRCT, whereas group B (BTA >60°) and C (BTA <55°) had variations in the alignment of middle ear structures to their corresponding inner ear structures. CONCLUSION: The association of BTA to the correlation between middle ear and inner ear structures can determine the orientation of the cochlea. This evaluation makes the surgeon aware of intraoperative challenges and helps in surgical planning.
Health literacy of patients eligible for cochlear implants.
Mavedatnia D, Wang L, Kiss A … +2 more , Monteiro E, Lin V
Cochlear Implants Int · 2024 Mar · PMID 38810103 · Publisher ↗
BACKGROUND: Hearing loss is known to be an independent risk factor for inadequate health literacy. The objective of this study was to assess the level of health literacy among patients undergoing cochlear implantation to...
BACKGROUND: Hearing loss is known to be an independent risk factor for inadequate health literacy. The objective of this study was to assess the level of health literacy among patients undergoing cochlear implantation to determine areas for improvement in delivery of patient information. METHODS: A cross-sectional survey was conducted at the otology-neurotology clinic at Sunnybrook Health Sciences Centre. Patients eligible for cochlear implantation completed two health literacy screening tools: The Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Brief Health Literacy Screen (BHLS). RESULTS: Thirty seven patients were included (41% female, 59% male, mean age: 55 years). Most patients had adequate health literacy through BHLS (76%) and S-TOFHLA (98%) scoring. Over 80% of patients were not able to correctly recount all the operative risks associated with cochlear implant surgery and one third of patients did not correctly recount any risks associated with a cochlear implant surgery. Female sex was associated with higher scores (p=0.03) and low income (<$35,000) was associated with lower scores (p=0.05). CONCLUSION: Patients eligible for cochlear implants have adequate health literacy, but most are not able to recount operative risks. Educational tools are required to improve patient retention, understand, and perioperative health information delivery.
Self-reported social well-being of children with hearing loss in 2023.
Hammer L, Kamper NR, Jantzen L … +2 more , Serafin S, Percy-Smith L
Cochlear Implants Int · 2024 May · PMID 38745418 · Publisher ↗
OBJECTIVES: To study the level of social well-being for children with hearing loss (HL) using self-completed questionnaires. METHODS: The data sample relates to a total of 22 children representing a new group of children...
OBJECTIVES: To study the level of social well-being for children with hearing loss (HL) using self-completed questionnaires. METHODS: The data sample relates to a total of 22 children representing a new group of children with HL. This new group is defined as HL detected through neonatal hearing screening and fitted with hearing technology when relevant before 6 months, received bilateral cochlear implants before one year of age followed by specific educational training using the auditory-verbal practice. The age range was from 9 to 12 years. Two self-completed questionnaires were used: The California Bullying Victimisation Scale (CBVS) and the Strengths and Difficulties Questionnaire (SDQ). The project design was a prospective case series. RESULTS: Self-completed assessments revealed levels of social well-being for both questionnaires comparable to populations with normal hearing. CBVS results showed that a total of 52.6% reported being 'not a victim', 36.8% peer victims and 10.5% bully victims. Results from SDQ revealed that 94.7% of the children reported being within the normal level for scores on both social strength and difficulties, 5.3% scored slightly raised/lowered and 0% had high/low scores or very high/low scores. CONCLUSION: The new group of children with HL presented with self-completed scores comparable to peers with normal hearing. It is time to raise expectations for children with HL in terms of not only outcomes on audition and spoken language but also most importantly on levels of social well-being. Furthermore, it is discussed whether this new group can also be defined as a new generation of children with HL.
Evaluating calcium channel blockers and bisphosphonates as otoprotective agents in cochlear implantation hearing preservation candidates.
Yancey KL, Patro A, Smetak M … +6 more , Perkins EL, Isaacson B, Bennett ML, O'Malley M, Haynes DS, Hunter JB
Cochlear Implants Int · 2024 Mar · PMID 38738388 · Publisher ↗
OBJECTIVES: Evaluate potential effects of calcium channel blockers (CCB) and bisphosphonates (BP) on residual hearing following cochlear implantation. METHODS: Medications of 303 adult hearing preservation (HP) candidate...
OBJECTIVES: Evaluate potential effects of calcium channel blockers (CCB) and bisphosphonates (BP) on residual hearing following cochlear implantation. METHODS: Medications of 303 adult hearing preservation (HP) candidates (low frequency pure tone average [LFPTA] of 125, 250, and 500 Hz ≤80 dB HL) were reviewed. Postimplantation LFPTA of patients taking CCBs and BPs were compared to controls matched by age and preimplantation LFPTA. RESULTS: Twenty-six HP candidates were taking a CCB (N = 14) or bisphosphonate (N = 12) at implantation. Median follow-up was 1.37 years (range 0.22-4.64y). Among subjects with initial HP, 29% (N = 2 of 7) CCB users compared to 50% (N = 2 of 4) controls subsequently lost residual hearing 3-6 months later (OR = 0.40, 95% CI = 0.04-4.32, 0.58). None of the four BP patients with initial HP experienced delayed loss compared to 50% (N = 2 of 4) controls with initial HP (OR = 0.00, 95% CI = 0.00-1.95, P0.43). Two CCB and one BP patients improved to a LFPTA <80 dB HL following initial unaided thresholds that suggested loss of residual hearing. DISCUSSION: There were no significant differences in the odds of delayed loss of residual hearing with CCBs or BPs. CONCLUSION: Further investigation into potential otoprotective adjuvants for maintaining residual hearing following initial successful hearing preservation is warranted, with larger cohorts and additional CCB/BP agents.
Comparative executive function analysis: Cochlear implants and normal hearing in 7- to 11-year-old children from Iran.
Divsalar P, Radman M, Pourhosseinali L … +3 more , Eslami-Shahrbabaki M, Aamizadeh M, Afsharmanesh J
Cochlear Implants Int · 2024 May · PMID 38662957 · Publisher ↗
OBJECTIVE: This study compares executive functioning in deaf children with cochlear implants and those with normal hearing. Individuals who lacked auditory stimulation during their early years might experience cognitive...
OBJECTIVE: This study compares executive functioning in deaf children with cochlear implants and those with normal hearing. Individuals who lacked auditory stimulation during their early years might experience cognitive challenges that extend beyond just speech and language abilities. METHODS: The executive functioning abilities of a group of 32 children who were born deaf and received cochlear implants before the age of 7 were contrasted with those of 30 children with normal hearing. Both sets of children underwent assessments using the Tower of London, BRIEF, and Stroop tests. RESULTS: The average score on the Tower of London task reveals that children who received cochlear implants (4.03 ± 2.53) achieved lower scores than typically hearing children (8.37 ± 2.79). This group also exhibited higher errors in the Stroop test and slightly longer response times Additionally, in terms of emotional control assessed by the BRIEF, a higher score was recorded. Notably, significant differences between the two groups were identified for organizing materials (t(62) = -4.204, = 0.00). The tests measuring phonemic fluency, categorical fluency, and working memory also revealed significant differences. CONCLUSIONS: The significant differences in data between both groups suggest the influence of cochlear implantation on cognitive functions. This emphasizes the importance of a holistic approach to supporting the overall development of these children.
Pneumatocoele after cochlear implantation with lateral petrosectomy: A minor complication?
Pietro C, Elena C, Domenico M … +5 more , Anna S, Andrea I, Ilaria O, Luisa C, Marco B
Cochlear Implants Int · 2024 Mar · PMID 38659150 · Publisher ↗
OBJECTIVE: To illustrate the clinical features and management of pneumatocoele presenting with a trap-valve mechanism after cochlear implantation with lateral petrosectomy (LP) in comparison with literature. INTRODUCTION...
OBJECTIVE: To illustrate the clinical features and management of pneumatocoele presenting with a trap-valve mechanism after cochlear implantation with lateral petrosectomy (LP) in comparison with literature. INTRODUCTION: Pneumatocoele is a rare complication of cochlear implant (CI) surgery, generally managed with conservative treatments. METHODS: We describe a progressively increasing pneumatocoele with a trap-valve mechanism occurring one year after CI with LP, successfully managed with revision surgery. Literature review was performed on this topic. RESULTS: Our case was the second ever reported in literature. It appeared consequently to forceful nose-blowing in a patient with refractory nasal polyposis. Unlike the pneumatocoeles reported after standard CI, we advised revision surgery as well as in the case of pneumatocoele after staged LP and CI. In both the patients subcutaneous air collection occurred as a late complication and an insufficient Eustachian tube closure was disclosed, which is considered a complication of LP itself. Surgical management was necessary in consideration of the risk of ascending infections associated with Eustachian tube patency in LP with CI. CONCLUSION: We consider surgical treatment mandatory in pneumatocoele after CI with LP, it is indeed the sentinel of the restoration of Eustachian tube patency and the potential prelude to major complications.
Paediatric percutaneous bone anchored hearing aid implant failures: Comparing the experience of a tertiary centre with a systematic review of the literature and meta-analysis.
Bradley M, Shields C, Sabourn R … +4 more , Whittle E, Boyd R, Bruce IA, Nichani J
Cochlear Implants Int · 2024 Jul · PMID 38591756 · Publisher ↗
BACKGROUND: Despite the proven audiological benefits of Percutaneous Bone Anchored Hearing Aids (BAHAs) in paediatric patients with conductive or mixed hearing loss, their adoption has been limited due to concerns over i...
BACKGROUND: Despite the proven audiological benefits of Percutaneous Bone Anchored Hearing Aids (BAHAs) in paediatric patients with conductive or mixed hearing loss, their adoption has been limited due to concerns over implant failure and associated complications. This paper conducts a systematic review and meta-analysis to assess the prevalence of implant failure in paediatric populations, combined with a case series from our tertiary referral centre. METHODS: A comprehensive literature search identified 562 articles, from which 34 were included in the review, covering 1599 implants in 1285 patients. Our retrospective case series included consecutive patients from our tertiary referral centre who underwent percutaneous BAHA implantation from 2003-2019. RESULTS: Meta-analysis revealed an overall implant failure rate of 11%, predominantly attributed to traumatic extrusion. Our retrospective case series comprised 104 implantations in 76 patients, with a 4.8% failure rate. DISCUSSION: Factors contributing to the lower-than-expected failure rates in the case series likely included consistent use of 4 mm fixtures from a single manufacturer and older age at implantation. The study underscores the need for standardised reporting formats in bone conduction implants research, given the systematic review's limitations in study design heterogeneity, especially with the expected rise in the adoption of novel active devices.
Comparative analysis of microstructures of narrative abilities in language-age-matched Tamil-speaking children with cochlear implants and typical hearing.
Venkatraman K, Ganesh L, Muthu J
Cochlear Implants Int · 2024 Sep · PMID 38566490 · Publisher ↗
In a unique exploration of narrative development among Tamil-speaking children, this study delves into the intricacies of linguistic expression, explicitly comparing the microstructure of narratives in two distinct group...
In a unique exploration of narrative development among Tamil-speaking children, this study delves into the intricacies of linguistic expression, explicitly comparing the microstructure of narratives in two distinct groups: those with hearing differences (HD) and those with normal hearing. A total of 30 children were included in the study, with 15 children in each group, matched for language age between 3-5 years on standard language tests. The children were asked to retell a story they had listened to, and the obtained samples were transcribed verbatim and analyzed for various microstructural elements, including the mean length of utterances, total number of words, number of utterances, and number of different word types. The results revealed that children with hearing loss used fewer words and simpler sentences during retelling despite having the same language age as their peers. This highlights the importance of incorporating narrative assessment in standard language evaluations. Furthermore, the findings emphasise integrating narrative intervention into language intervention programs to enhance language productivity. Overall, this study provides valuable insights into the narrative abilities of Tamil-speaking children with cochlear implants and underscores the significance of addressing narrative skills in language intervention approaches.
Awareness campaigns for cochlear implants: Are we making an impact?
Kang JM, Bentan M, Coelho DH
Cochlear Implants Int · 2024 Mar · PMID 38561981 · Publisher ↗
OBJECTIVE: This study aimed to determine if the major public awareness campaign for cochlear implants 'International Cochlear Implant Day' influenced national and international public interest as measured by internet sea...
OBJECTIVE: This study aimed to determine if the major public awareness campaign for cochlear implants 'International Cochlear Implant Day' influenced national and international public interest as measured by internet search activity. METHODS: Weekly search volume data in the United States, Canada, Australia, Germany, United Kingdom, Brazil, India, Japan, and a 'Worldwide' group for the search topic 'cochlear implant' was collected from Google Trends over a 5-year period (2017-2021). The 'Campaign' window was defined as 1 week before, the week of, and 2 weeks after International Cochlear Implant Day (February 25th). 'Non-Campaign' weeks were considered any data outside the 'Campaign' window. RESULTS: Of the studied regions, the United States, United Kingdom, Australia, India, and 'Global' demonstrated a significant increase in internet search activity between 2017 and 2021. Although some individual years showed significant increases during the 'Campaign' period for Canada, Germany, Brazil, and Japan, none showed statistically significant increases over the 5-year period studied. CONCLUSION: Public awareness campaigns are recognized crucial elements to delivering effective healthcare, but their success varies worldwide. While data from Google Trends suggests that cochlear implant awareness campaigns can translate into increased internet searches, greater efforts can be made in select countries to improve public interest.
Influence of cochlear implantation on the working ability of hearing-impaired patients: A prospective study on potential influencing factors.
Lailach S, Martin J, Stephan P … +3 more , Kronesser D, Zahnert T, Neudert M
Cochlear Implants Int · 2024 Mar · PMID 38532283 · Publisher ↗
PURPOSE: This study evaluates the effect of cochlear implantation (CI) on work ability. The influences of quality of life (QOL), age, mental health, and hearing were analyzed. METHODS: Seventy-nine patients undergoing CI...
PURPOSE: This study evaluates the effect of cochlear implantation (CI) on work ability. The influences of quality of life (QOL), age, mental health, and hearing were analyzed. METHODS: Seventy-nine patients undergoing CI surgery were evaluated preoperatively and 12 months postoperatively. Work ability was evaluated using the Work Ability Index (WAI). QOL was assessed with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the WHOQOL-BREF. Mental health was assessed with the Patient Health Questionnaire. RESULTS: The WAI was unaffected by CI (Δ 0.8 ± 6.8, = 0.42). No significant changes in WAI were observed for employees (Δ - 1.1 ± 5.7, = 0.25) and pensioners (Δ -0.4 ± 7.8, = 0.73). Patients without elevated depressiveness, stress, or somatoform symptoms had significantly better WAI.The multiple regression analyses show that WHOQOL-BREF (ß = 0.49, ≤ 0.001), age (ß = -0.34, ≤ 0.001), and depressiveness (ß = 0.33, = 0.04) were significantly associated with WAI. In the employee group, the NCIQ (ß = 0.58, = 0.008) had the strongest association with the WAI. CONCLUSION: Age, mental health, and QOL are predictive factors for work ability. This should be considered in the consultation and the rehabilitation process.
More than 40 years of cochlear implant research: A bibliometric analysis.
Abari J, Tekin AM, Bahşi I … +1 more , Topsakal V
Cochlear Implants Int · 2024 May · PMID 38512716 · Publisher ↗
OBJECTIVES: Cochlear implantation is the most effective treatment for patients with severe-to-profound sensorineural hearing loss. Much scientific work has been published since their inception. There is a need for a crit...
OBJECTIVES: Cochlear implantation is the most effective treatment for patients with severe-to-profound sensorineural hearing loss. Much scientific work has been published since their inception. There is a need for a critical reflection on how and what we publish on cochlear implantation. METHODS: All Science Citation Index Expanded featured articles between 1980 and 2022 with the word 'cochlear implants' or 'cochlear implantation' were collected from the Web of Science database. Separate characteristics, such as the publication dates, the journals, the number of citations, the countries of origin, the authors, the institutions and co-occurring keywords, were assessed. RESULTS: 13,934 articles were included in the data analysis. The journals of of Otology and Neurotology, Ear and Hearing and of Pediatric Otorhinolaryngology represent the top three most publishing journals. Hannover Medical School, the University of Melbourne and the University of Northern Iowa represent the top three most publishing institutions. DISCUSSION: The amount of scientific publications on cochlear implant technology has increased for the last 40 years. Besides the focus on speech perception, the research landscape on cochlear implantation is broad and diverse. The number of countries and institutions contributing to these publications is limited. CONCLUSION: This bibliometric analysis serves as a quantitative overview of the research landscape on cochlear implantation.
Pure endoscopic transcanal revision cochlear implantation for a misplaced electrode array: A novel and minimally invasive approach.
Gülşen S, Çıkrıkcı S
Cochlear Implants Int · 2024 May · PMID 38411200 · Publisher ↗
OBJECTIVES: Misplacement of the CI electrode array is one of the rarest complications of cochlear implant surgery. This condition can be noticed intraoperatively and diagnosed radiologically in the early postoperative pe...
OBJECTIVES: Misplacement of the CI electrode array is one of the rarest complications of cochlear implant surgery. This condition can be noticed intraoperatively and diagnosed radiologically in the early postoperative period. To present a novel and minimally invasive revision approach for a misplaced cochlear implant (CI) electrode array. CASE: In this case report, the authors present a previously undescribed alternative minimally invasive revision cochlear implantation approach for a patient with a misplaced CI electrode array in the right ear who underwent bilateral simultaneous cochlear implantation one and a half years ago at another center. CONCLUSION: To correct CI electrode array misplacement, the endoscopic transcanal approach is a safe and effective alternative to the conventional approach.
Salvage of the cochlear implant in cases of skin breakdown over the receiver/stimulator in children.
Hovev Z, Silberstein E, Kaplan DM
Cochlear Implants Int · 2024 Mar · PMID 38408736 · Publisher ↗
OBJECTIVE AND METHOD: Skin breakdown over receiver/stimulator (RS) after cochlear implantation poses a serious challenge. We report our experience using a one-stage reconstruction and implant salvage approach. RESULTS: B...
OBJECTIVE AND METHOD: Skin breakdown over receiver/stimulator (RS) after cochlear implantation poses a serious challenge. We report our experience using a one-stage reconstruction and implant salvage approach. RESULTS: Between the years 2005 and 2017 five children, all females, with congenital- bilateral sensorineural hearing loss were identified. In all cases, a temporoparietal fascia flap (TPFF) and a large scalp flap were used to provide a two-layer coverage to the exposed RS. In the first three cases, a split-thickness skin graft was used to cover the donor site defect. In the latter two cases, a larger rotation flap was used, and a skin graft was not required. One case required revision due to the dehiscence of the wound and exposure of the RS. In another case, an accidental electrode array explantation occurred and the patient underwent a revision cochlear implantation. All patients had achieved complete healing and no change in hearing thresholds with the implants. CONCLUSIONS: We demonstrate our one-stage salvage technique with TPFF that saves the implant and prevents a two-stage procedure. The success rate can be improved with special care at reconstruction and with better protection of the implant during the procedure.
Migration and other electrode complications following cochlear implantation.
Magos T, Kanona H, Morley S … +2 more , Khalil S, Shaida A
Cochlear Implants Int · 2024 May · PMID 38383952 · Publisher ↗
OBJECTIVES: To investigate migration and other electrode-related complications in cochlear implant surgery. METHODS: Retrospective review of all patients (adult and paediatric) undergoing cochlear implantation at a terti...
OBJECTIVES: To investigate migration and other electrode-related complications in cochlear implant surgery. METHODS: Retrospective review of all patients (adult and paediatric) undergoing cochlear implantation at a tertiary referral centre in England, between April 2019 and December 2021. Split arrays and patients who did not have post-op imaging were excluded. RESULTS: Two hundred and ninety-nine cochlear implants were performed including 90% primary and 10% revision surgeries. Two hundred and forty-eight (86%) of electrodes implanted were straight arrays.Twenty-seven (9%) demonstrated suboptimal position on post-operative imaging. Three (11%) were true migration, 4 (15%) possible migration, 15 (56%) had two or less extra-cochlear electrodes, 3 (11%) expected partial insertion and 2 (7%) demonstrated tip fold-overs. Twenty (74%) of arrays within the suboptimal insertion group were in primary surgeries. Six patients required re-implantation. The most common reason for re-implantation was migration. DISCUSSION: Electrode migration after cochlear implantation may be more common than previously thought. We demonstrate rates of migration congruous with current literature; this is despite robust and varied fixation techniques. Notable in our series is that all true captured migrations were seen exclusively in straight arrays. The majority of patients in the possible and confirmed migration group had normal inner ear anatomy. CONCLUSION: Suboptimal electrode position following cochlear implant surgery is a recognized complication and can affect implant performance. Reporting may increase with more widespread use of sophisticated post-operative imaging. Use of a pre-curved electrode and routine use of appropriate fixation techniques may reduce migration rates.
Cochlear-facial dehiscence - the most common cause of facial nerve stimulation from a cochlear implant? A case-control study.
Bunne M, Myhrum M, Iftikhar M … +2 more , Rasmussen K, Falkenberg-Jensen B
Cochlear Implants Int · 2024 Mar · PMID 38373739 · Publisher ↗
To investigate the prevalence of cochlear-facial dehiscence (CFD) and other radiographical pathologies in ears with facial nerve stimulation (FNS) from a cochlear implant (CI). Retrospective case-control study of 27 pat...
To investigate the prevalence of cochlear-facial dehiscence (CFD) and other radiographical pathologies in ears with facial nerve stimulation (FNS) from a cochlear implant (CI). Retrospective case-control study of 27 patients with CI and FNS on either ear (study group) and 27 patients without FNS, matched for age, sex and type of electrode array (control group). Preoperative CT scans of all 108 ears were re-evaluated. Subanalyses included comparisons between the study and control groups and associations between FNS and radiographic pathologies. CFDs were detected in 20 of 54 ears (37%) in the study group and in 3 of 54 ears (6%) in the control group (P< 0.001). The corresponding numbers of otosclerosis were 10 (18%) and 0 (P= 0.011) and of developmental anomalies 16 (30%) and 8 (15%) (not significant). FNS was present in 33 ears in the study group, of which 14 (42%) had a CFD. FNS was absent in six ears with CFD and CI, four of which contralateral to an ear with FNS. Eight of 14 ears with FNS and CFD had a lateral electrode array and six had a perimodiolar electrode array. We found no association between the presence of CFD and stimulation thresholds for FNS. The adjusted odds ratio for developing FNS in the presence of a CFD was 9.9 (95% CI 2.7-36.0). CFD was the most common radiographic pathology in ears with FNS, with a 10-fold increased risk of FNS. To avoid CI-related FNS, preoperative CT scan and awareness of typical dehiscence symptoms are strongly recommended.
Factors that influence performance in pediatric cochlear implant recipients with cochlear nerve deficiency.
Thompson NJ, Park LR, O'Connell BP … +3 more , Zdanski CJ, Brown KD, Anderson MR
Cochlear Implants Int · 2024 May · PMID 38353257 · Publisher ↗
OBJECTIVES: Children with cochlear nerve deficiency (CND) have wide variability in outcomes with cochlear implant (CI) use. The current study aims to report a large cohort of pediatric CI recipients with CND and to evalu...
OBJECTIVES: Children with cochlear nerve deficiency (CND) have wide variability in outcomes with cochlear implant (CI) use. The current study aims to report a large cohort of pediatric CI recipients with CND and to evaluate for factors that may predict improved performance. METHODS: The current study is a retrospective review of pediatric CI recipients with CND at a tertiary academic hospital. Variables including cochlear nerve status (hypoplasia vs aplasia), age at implantation, cochleovestibular malformation, bony cochlear nerve aperture, internal auditory canal aperture, and cognitive delay were evaluated for predictors of postoperative performance. A stepwise multinomial regression analysis was performed. RESULTS: Forty-seven CI recipients (54 ears) were included in the analysis. A majority (59%) showed auditory capabilities with their CI. Twenty percent of recipients achieved some level of open-set speech perception with their CI. The regression analysis identified cochlear nerve status and cognitive delay as predictors of performance. CI recipients with cochlear nerve hypoplasia had significantly improved performance compared to those with aplasia ( = 0.003). Recipients with cognitive delay had more limited benefit than those without cognitive delay ( = 0.033). CONCLUSIONS: Children with CND can benefit from CI use, with outcomes spanning from non-use to development of spoken language. Predictive factors for improved performance include a lack of cognitive delay and cochlear hypoplasia rather than aplasia. These can be important considerations for parent counseling and decision making.
Intraoperative and postoperative findings in children with myringotomy tubes (MT) undergoing cochlear implantation (CI).
Robbins AM, Vaughn WL, Voyles CB … +4 more , Tey CS, Xiang Y, Zhang C, Govil N
Cochlear Implants Int · 2024 Mar · PMID 38247269 · Publisher ↗
OBJECTIVE: To evaluate and compare children undergoing cochlear implantation (CI) with myringotomy tubes (MT) placed preoperatively or intraoperatively to those without MT . METHODS: This was a retrospective review of pe...
OBJECTIVE: To evaluate and compare children undergoing cochlear implantation (CI) with myringotomy tubes (MT) placed preoperatively or intraoperatively to those without MT . METHODS: This was a retrospective review of pediatric patients undergoing CI between 2015 to 2020 at a tertiary care pediatric hospital. CI patients with and without MT were reviewed for the following outcomes: intraoperative findings, intraoperative and postoperative complications, and surgical time. Descriptive and bivariable statistical analysis was performed. RESULTS: 192 cochlear implant surgeries were included: 116 without MT tubes and 76 with a history of MT. Twenty-six patients had MT present at the time of CI surgery. No statistical difference existed between patients with MT (CI + MT group) and those without MT (CI - MT group) with regard to intraoperative complications (P = 0.760) and intraoperative findings (P = 0.545). MT association with total post-operative complications (GEE) showed no statistical significance (OR 2.45, 95% CI 0.83-7.22, P-value 0.105). CI + MT patients were significantly more likely to have inflamed middle ear mucosa at time of surgery (P = 0.003). CI + MT patients did not have a longer length of surgery compared to the CI - MT group (3.47 h vs 3.3 h, respectively, P = 0.342). CONCLUSION: Our data confirms it is safe to perform CI in ears with myringotomy tubes, although the surgeon should be aware of possibly encountering increased middle ear inflammation during the surgery.
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