Adult Simultaneous Cochlear Implantation: Local Anesthesia.

Nawaf Fatani, Asma Alahmadi, Yousef Almassalmeh, Ahmad M Abdelrahman, Nasser Alotaibi, Medhat Yousef, Mohammed Alotaibi, Fares Aldokhayel, Abdulrahman Hagr
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Abstract

Purpose: Cochlear implant (CI) surgery is conventionally done under general anesthesia (GA). However, many patients are unable to undergo GA due to various reasons, raising the need for an alternative safe option. CI under local anesthesia is feasible and safely done in patients who can't tolerate GA. This approach allows for device fitting immediately after surgery. This study aims to evaluate simultaneous bilateral cochlear implant (BiCI) surgery performed under local anesthesia with sedation in adults. To our knowledge, this is the largest cohort of patients who underwent this approach. Methods: This is a retrospective chart review in a tertiary center. We included all adult patients who underwent simultaneous BiCI under local anesthesia with sedation from 2018 to 2024. The feasibility of BiCI under local anesthesia with sedation was assessed through clinical, surgical, audiological, and patient questionnaire data. Results: Six patients underwent simultaneous BiCI with local anesthetic and sedation. Mean age was 41.7 ± 16.0, comprising 66.7% male and 33.3% female. No intraoperative problems were encountered. All woke up from sedation without any agitation or difficulties. Their recovery was uneventful. No dizziness, nausea, or vomiting were reported. The device was activated immediately postoperatively. Pure tone audiometry, speech reception threshold, and word recognition score were significantly improved. Positive experiences were reported in all patients. Conclusion: Bilateral simultaneous cochlear implantation under local anesthesia in adults is achievable, through a multidisciplinary approach. This approach is a potential alternative option for some patients and could optimize their hearing rehabilitation.

成人同步耳蜗植入术:局部麻醉。
目的:人工耳蜗植入(CI)手术通常在全身麻醉(GA)下进行。然而,许多患者由于各种原因无法接受全身麻醉,因此需要另一种安全的选择。对于无法忍受全身麻醉的患者来说,在局部麻醉下进行 CI 是可行且安全的。这种方法允许术后立即安装设备。本研究旨在评估在局部麻醉和镇静下同时进行的成人双侧人工耳蜗植入(BiCI)手术。据我们所知,这是接受这种方法的最大一批患者。方法:这是在一家三级医疗中心进行的回顾性病历审查。我们纳入了 2018 年至 2024 年期间在局麻镇静下接受同步 BiCI 的所有成人患者。通过临床、手术、听力学和患者问卷调查数据评估了镇静局部麻醉下 BiCI 的可行性。结果:六名患者在局部麻醉和镇静的情况下同时进行了 BiCI。平均年龄为(41.7 ± 16.0)岁,其中男性占 66.7%,女性占 33.3%。术中未出现任何问题。所有人都从镇静中醒来,没有任何躁动或困难。术后恢复顺利。没有头晕、恶心或呕吐的报告。术后立即启动了设备。纯音测听、言语接收阈值和单词识别评分均有明显改善。所有患者都获得了积极的体验。结论通过多学科方法,在局部麻醉下对成人进行双侧同步人工耳蜗植入是可行的。这种方法对某些患者来说是一种潜在的替代选择,可以优化他们的听力康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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