Surgical complications and morbidity in cochlear implantation

Abstract

Introduction: Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe-to-profound hearing loss. This is a safe and standard procedure in the hands of experienced implant surgeons. Complications due to surgery are minimal and are often encountered in cases of congenital anomalies of the temporal bone and inner ear. Patients and Methods: All patients receiving CI at our institution between 2014 and 2015 were included in the study. Aim: The aim of this study was to report the frequency of surgical complications following 112 consecutive CIs in 102 children and 10 adults in the National Hearing and Speech Institute (HIS), Cairo, Egypt. The international consensus on the reporting of CI complications proposed by Hansen and colleagues was used and evaluated. Results: In all, 112 implantations were performed in 102 pediatric and 10 adult patients. Overall, complications occurred in 21 (18.75%) patients, including minor complications in nine (8.03%) and major complications in 12 (10.71%) cases. Complications were delayed in nine (8.03%) cases. No death was attributed to device implantation. Major complications occurred in 12 cases, which included misplaced electrodes in two cases, cerebrospinal fluid leak (gusher) in four cases, labyrinthitis ossificans in one patient, magnet displacement in one case (chronic suppurative otitis media), central perforation in one case, seroma and hematoma (severe cutaneous infections) in one case, wound infection in one case, and persistent pain/discomfort (migration) in one case. Conclusion: Complications of CI are more common in children than in adults with trauma as a major factor. Inner ear malformations should prompt specific preventive management. CI in young children did not appear to be a risk factor in this study.