Cochlear reimplantation outcomes over 20 years: Expertise in reimplantation surgery and auditory-speech rehabilitation.

Autor: Chen Z; Department of Otolaryngology-Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China., Bi Q; Department of Otolaryngology-Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China., Lv Y; Department of Otolaryngology-Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China., Li Y; Department of Otolaryngology-Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China., Yang W; Department of Otolaryngology-Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China., Xu X; Department of Otolaryngology-Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China., Li Y; Department of Otolaryngology-Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China. Electronic address: yuanli0702@263.net.
Jazyk: angličtina
Zdroj: American journal of otolaryngology [Am J Otolaryngol] 2024 Sep-Oct; Vol. 45 (5), pp. 104400. Date of Electronic Publication: 2024 Jul 21.
DOI: 10.1016/j.amjoto.2024.104400
Abstrakt: Objectives: The aim of this study was to present an institution's experience with cochlear reimplantation (CRI), to assess surgical challenges and post-operative outcomes and to increase the success rate of CRI.
Study Design: Retrospective single-institution study.
Setting: Tertiary medical center.
Methods: We retrospectively evaluated data from 76 reimplantation cases treated in a tertiary center between 2001 and 2022. Clinical features including etiology of hearing loss, type of failure, surgical issues, and auditory speech performance were analyzed. Categorical Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were used to evaluate pre- and post-CRI outcomes.
Results: The CRI population comprises of 7 patients from our institute,69 referred patients from other centers. Device failure was the most common reason (68/76, 89.5 %) for CRI; in addition, there were 7 medical failures and 1 had both soft device failure. Medical failures included flap rupture and device extrusion, magnet migration, auditory neuropathy, leukoencephalopathy, foreign-body residue and meningitis. In 21/76 patients, the electrode technology was upgraded. The mean time to failure was 0.58-13 years, with a mean of 4.97 years. The mean (± SD) CAP and SIR scores before and after CRI were 5.2 ± 1.2 versus 5.5 ± 1.1 and 3.4 ± 1.1 versus 3.5 ± 1.1, respectively. Performance was poor in six patients with severe cochlear malformation, auditory nerve dysplasia, leukoencephalopathy, and epilepsy.
Conclusion: CRI surgery is a challenging but relatively safe procedure, and most reimplanted patients experience favorable postoperative outcomes. Medical complications and intracochlear damage are the main causes of poor postoperative results. Therefore, adequate preoperative preparation and atraumatic CRI should be carried out for optimal results.
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests. The authors alone are responsible for the content and writing of this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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