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Complications Common, Often Linked to Trauma in Children Receiving Cochlear Implants CHICAGO -- January 18, 2010 -- Some complications may occur in children receiving cochlear implants, and are highly correlated with trauma to the ear area and inner ear malformation, according to a report in the January issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals. Cochlear implants are electronic devices that can help provide a sense of sound to individuals who are deaf or severely hearing impaired. “The success of cochlear implantation as an auditory rehabilitative tool requires a thorough knowledge of indications, limitations, and potential risks,” the authors wrote as background information in the article. “Since 1990, the number of paediatric cochlear implants has increased significantly, and more specific paediatric evaluation of the medical and surgical risks can be collected.” Natalie Loundon, MD, Hôpital d’Enfants Armand-Trousseau, Paris, France, and colleagues studied 434 patients who underwent cochlear implantation at one facility between 1990 and 2008. All patients were aged younger than 16 years at the time of operation (average age 4.7 years), 41 (9.4%) were younger than 24 months, and 43 (9.9%) had inner ear malformations. They were followed up for an average of 5.5 years, with complications tracked and classified as early (0 to 8 days) or delayed (more than 8 days after surgery), and major (requiring a new admission and/or extended hospital stay) or minor. A total of 43 patients (9.9%) experienced complications during the follow-up period. Of these, 28 (65.1%) were delayed, with an average delay of 2.2 years. Thirteen of the 43 patients (30.2%) underwent re-implantation as a result of their complications. Twenty-four (5.5%) of the patients had major complications, including severe infections (15 cases), displacement of the magnet (3), meningitis (2), skin cyst in the middle ear (2), cerebrospinal fluid leak (1), and misplacement of the electrode (1). Nineteen (4.4%) of the participants had minor complications, including vertigo (9 patients), soft-tissue infections (5), persistent inflammation of the middle ear (4), and facial paralysis (1). “Trauma to the mastoid area [14 patients] and inner ear malformations [51] were highly correlated with major delayed complications and early minor complications, respectively,” the authors wrote. “Young age at cochlear implantation was not correlated with any type of complication.” The findings show that complications associated with cochlear implants are not rare and can often be delayed, they noted. “The finding of complications several years after surgery highlights the need for long-term medical follow-up in this population and the importance of repeatedly providing information to the patients and their family,” they concluded. “The specific features of paediatric cochlear implantation warrant a specialised, experienced care centre.” SOURCE: Archives of Otolaryngology-Head & Neck Surgery E-mail this page to a friend or colleague! To print, use this version