What Did We Learn from Our Cochlear Implant Revisions?

Abstract

Introduction: We aimed to report our clinic's 11-year experience with cochlear implant (CI) revision surgeries.

Materials and methods: This was a retrospective observational study. Patients who underwent CI and revision surgery at the same tertiary institution were enrolled in the study. Patients whose primary surgery was performed at another institution were excluded from the study. The patients' clinical charts, surgical records, and audiological and oral language outcomes were retrospectively examined.

Results: Thirty-three (29 children, 4 adults) of 720 patients (871 CI) at our clinic required revision surgery, representing a revision surgery rate of 4.58%. The most common reason for revision was device failure (10 patients), followed by skin and electrode problems, with electrode tip fold-over in 6 patients, a broken electrode cable in 1 patient, skin flap complications in 6 patients, displacement of the magnet in 1 patient, cholesteatoma in 1 patient, electrode migration in 6 patients, misplacement of the electrode array into the internal acoustic canal in 1 patient, and explantation of the electrode cable in the external auditory canal in 1 patient. We had only one major complication after revision surgery.

Conclusion: We recommend performing routine postoperative imaging, even if intraoperative telemetries are normal, to diagnose electrode misplacement or electrode tip fold-over. Additionally, we recommend long-term regular follow-up of children, in particular, because our study showed that the number of revision surgeries was higher in children who received implants at an early age.