Abstract
Introduction: Cochlear implantation is an effective method for hearing rehabilitation in patients with severe neurosensory hearing loss in which hearing aids do not provide good discrimination. Although cochlear implantation is a safe technique, adverse effects related to surgery have been described, including flap infection or facial paralysis. Objective: To analyze the complications of cochlear implanted patients in a tertiary university hospital: The Hospital Universitario Doctor Peset of Valencia, from January 2001 to March 2020. Methodology: This is a descriptive observational study of the complications in a sample of 134 patients with cochlear implant surgery in The Hospital Universitario Doctor Peset of Valencia in a period of 20 years. Descriptive statistics were used in the statistical analysis. To demonstrate significant differences between variables we used the R program. The χ2 test was used for proportions, considering significant a p value < 0.05. Results: 134 patients were implanted. The global frequency of complications was 17.9%, 4.5% were major complications and 13.4% were minor complications. The most frequent complication was inactivation or incomplete insertion of some electrodes. Discussion: Our complication rate is within the range published in the literature (14.9-18.3%). The major complication rate is 5% which is similar to our series. Conclusions: The cochlear implant is a safe surgical technique for the rehabilitation of patients with severe neurosensory hearing loss, although it is not riskless, therefore, one must know that complication are possible.
References
Izquierdo Dominguez Y, Hernández Montero G, Alfonso Muñoz E. Caracterización epidemiológica de la hipoacusia neurosensorial en adultos mayores de 60 años. Rev Cubana Otorrinolaringol Cirug Cabeza Cuello. 2020;21(3):e177.
Organización Mundial de la Salud [Internet]. Ginebra; c2021. Sordera y pérdida de la audición. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/deafness-and-hearing-loss.
INEbase [Internet]. Madrid: Instituto Nacional de Estadística; 2008. Población con discapacidad o limitación según tipo de deficiencia de origen por edad y sexo. Disponible en: https://www.ine.es/jaxi/Datos.htm?path=/t15/p418/a2008/hogares/p01/modulo1/l0/&file=01010.px.
La Web del Implante Coclear [Internet]. Barcelona: Federación de Asociaciones de Implantados Cocleares de España (AICE); c2021. Día Internacional del Implante Coclear. Disponible en: http://implantecoclear.org/index.php?option=com_content&view=article&id=527:dia-internacional-ic&catid=1:latest-news&jjj=1617725430365.
Portillo C. Descripción y funcionamiento del implante coclear. En: MJ Manrique, A Huarte Irujo, editores. Implantes cocleares. Barcelona: Masson; 2002. p. 43-61.
Djourno A, Eyries C. Prothèse auditive par excitation électrique à distance du nerf sensoriel à l’aide d’un bodinage inclus à demeure. Presse Med. 1957 ;35:14-7.
Toner JG, John G, McNaboe EJ. Cochlear implantation under local anaesthesia, the Belfast experience. J Laryngol Otol. 1998;112(6):533-6. PubMed PMID: 9764291.
Manrique M, Ramos A, de Paula Vernetta C, Gil-Carcedo E, Lassaleta L, Sanchez-Cuadrado I, et al. Guideline on cochlear implants. Acta Otorrinolaringol Esp (Engl Ed). 2019;70(1):47–54. PubMed PMID: 29598832.
Hoffman R, Cohen, N. Complications of cochlear implant surgery. Ann Otol Rhinol Laryngol Suppl. 1995;166(Sep):420-2.
Farinetti A, Ben Gharbia D, Mancini J, Roman S, Nicollas R, Triglia JM. Cochlear implant complications in 403 patients: Comparative study of adults and children and review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131(3):177-82.
Venail F, Sicard M, Piron JP, Levi A, Artieres F, Uziel A, et al. Reliability and complications of 500 consecutive cochlear implantations. Arch Otolaryngol Head Neck Surg. 2008;134(12):1276-81.
Brito R, Monteiro TA, Leal AF, Tsuji RK, Pinna MH, Bento RF. Surgical complications in 550 consecutive cochlear implantation. Braz J Otorhinolaryngol. 2012;78(3):80-5.
Yu KC, Hegarty JL, Gantz BJ, Lalwani AK. Conservative management of infections in cochlear implant recipients. Otolaryngol Head Neck Surg. 2001;125(1):66-70.
Halawani, R, Aldhafeeri A, Alajlan S, Alzhrani F. Complications of post-cochlear implantation in 1027 adults and children. Ann Saudi Med. 2019;39(2):77-81.
Penna Lima Júnior LR, de Alencar Rodrigues Junior F, Dias Ferreira Calhau CM, Dias Ferreira Calhau AC, Terra de Paiva Palhano C. Postoperative complications in implanted patients in the cochlear implant program of Rio Grande do Norte - Brazil. Braz J Otorhinolaryngol. 2010;76(4):517-21.
Awad AH, Rashad UM, Gamal N, Youssif MA. Surgical complications of cochlear implantation in a tertiary university hospital. Cochlear Implants Int. 2018;19(2):61-6.
Qin F, Li W, Qiu J, Zhang L, Zhong M. After cochlear implantation: Complications related to flap around implants. J Otol. 2016;11(4):198-201.
Migirov L, Muchnik C, Kaplan-Neeman R, Kronenberg J. Surgical and medical complications in paediatric cochlear implantation: a review of 300 cases. Cochlear Implants Int. 2006;7(4):194-201.
Raghunandhan, S., Kameswaran, M., Anand Kumar, R. S., Agarwal, A. K. & Hossain, M. D. A Study of Complications and Morbidity Profile in Cochlear Implantation: The MERF Experience. Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):161-8.
Petersen H, Walshe P, Glynn F, McMahon R, Fitzgerald C, Thapa J, et al. Occurrence of major complications after cochlear implant surgery in Ireland. Cochlear Implants Int. 2018;19(6):297-306.
Connell SS, Balkany TJ, Hodges AV, Telischi FF, Angeli SI, Eshraghi AA. Electrode migration after cochlear implantation. Otol Neurotol. 2008;29(2):156-9.
Green KMJ, Bhatt YM, Saeed SR, Ramsden RT. Complications following adult cochlear implantation: experience in Manchester. J. Laryngol. Otol. 2004; 118(6): 417-420.
Bhatia K, Gibbin KP, Nikolopoulos TP, O’Donoghue GM. Surgical complications and their management in a series of 300 consecutive pediatric cochlear implantations. Otol. Neurotol. 2004; 25(5): 730-9.
Lee J, Nadol JB, Eddington DK. Factors associated with incomplete insertion of electrodes in cochlear implant surgery: a histopathologic study. Audiol. Neurotol. 2011; 16(2): 69-81.
Alzhrani F, Lenarz T, Teschner M. Facial palsy following cochlear implantation. Eur Arch Otorhinolaryngol. 2006; 273(2): 4199- 4207.
Thom JJ, Carlson ML, Olson MD, Neff BA, Beatty CW, Facer GW, et al. The prevalence and clinical course of facial nerve paresis following cochlear implant surgery. Laryngoscope. 2013;123(4): 1000-4.
Tarkan Ö, Tuncer Ü, Özdemir S, Sürmelioğlu Ö, Çetik F, Kıroğlu M, et al. Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations. Int J Pediatr Otorhinolaryngol. 2013; 77(4): 473-479.
Wei BP, Shepherd RK, Robins-Browne RM, Clark GM, O’Leary SJ. Pneumococcal meningitis post-cochlear implantation: preventative measures. Otolaryngol Head Neck Surg. 2010; 143(5): 9-14.
Cohen NL, Roland JT, Marrinan M. Meningitis in cochlear implant recipients: the North American experience. Otol Neurotol. 2004; 25(3): 275-281.
Biernath KR, Reefhuis J, Whitney CG, Mann EA, Costa P, Eichwald J, et al. Bacterial meningitis among children with cochlear implants beyond 24 months after implantation. Pediatrics. 2006; 117(2): 284-289.
Cubillana JD. Experiencia inicial (2003-2010) del programa de implantes cocleares del Hospital Clínico Universitario ‘Virgen de la Arrixaca’[Doctorado]. Universidad de Murcia; 2015.
Morgenstern L. Warning! Dangerous curve ahead: The learning curve. Surg Innov. 2005; 12(1):101-3.
Vallés H, Royo J, Adiego MI, Calvo MV, García E, Vergara JM, et al. Diez años de implantación coclear en Aragón. Acta Otorrinolaringol Esp. 2005; 56(8) 379-387.
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Médicas UIS