Management of Complications in 1452 Pediatric and Adult Cochlear Implantations

Turk Arch Otorhinolaryngol. 2020 Mar;58(1):16-23. doi: 10.5152/tao.2020.5025. Epub 2019 Dec 19.

Abstract

Objective: The aim of this study was to determine the short- and long-term complications after cochlear implantation (CI) procedures and to discuss the management and prevention of these complications.

Methods: The study included a total of 1452 pediatric and adult cochlear implantation procedures performed in our clinic from March 2000 through September 2019. Of the 1452 implantations, 1201 were performed in children and 156 in adults. The minimum follow-up period was three months and maximum was 19 years. The mean age of the patients was 6.7±3.9 years (range, 10 months-69 years) at the time of their respective procedures. Complications were classified as major complications requiring reimplantation, major complications not requiring reimplantation and minor complications. All postoperative complications and treatment methods were examined.

Results: A total of 148 (10.1%) complications were observed in the 1452 cochlear implants. Of these, 69 (4.75%) were major and 79 (5.44%) were minor complications. While 40 (2.75%) of the major complications required reimplantation, 29 (1.99%) did not. The most common cause of major complications leading to reimplantation was device failure (29 patients, 1.99%). The most common cause of minor complications was hematoma (21 patients). Total complication rates (6.68%) were significantly higher in children than in adults (3.51%) (p=0.00).

Conclusion: Our 19 years of clinical experience has shown that CI is a successful and safe procedure that can be performed with low major complication rates. It is important to know the possible complications and to manage them correctly.

Keywords: Cochlear implantation; complications; device failure; flap necrosis; meningitis.