Elective Versus Corrective Cochlear Implant Revision Surgery of Legacy Internal Devices.

Objective: To assess the time course of speech recognition restoration for recipients of legacy devices who underwent cochlear implant revision (CIR) surgery in the presence or absence of device failure.

Study design: Retrospective review.

Setting: Tertiary academic referral center.

Patients: Forty-four adult recipients of a first- or second-generation internal device who underwent CIR surgery.

Interventions: Cases were categorized by whether the CIR surgery was elective (n = 18) or corrective due to a hard (n = 7) or soft (n = 19) failure.

Main outcome measures: Aided consonant-nucleus-consonant (CNC) word recognition scores were queried for the following visits: best performance pre-CIR and 3, 6, and 12 months post-CIR. A linear mixed effects model evaluated the main effects of visit, CIR category, and age at CIR surgery, and the interaction of interval and revision category on CNC scores.

Results: Limited surgical challenges were reported (n = 4), which included one case of incomplete insertion of the new device. Post-CIR CNC scores were similar to the best pre-CIR scores by 6 months post-CIR ( p = 0.055). There was a significant effect of age ( p = 0.006), with better performance observed for younger adults. The time course of speech recognition restoration post-CIR did not differ significantly for cases of corrective CIR due to hard or soft failures or elective CIR ( F(2,40) = 0.08, p = 0.923).

Conclusions: Legacy CI users who undergo corrective or elective CIR may experience a similar time course in restoration of speech recognition post-CIR. Legacy device recipients considering elective CIR to access technology upgrades should be counseled on the associated potential risks and benefits.