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Rates of revision and device failure in cochlear implant surgery: a 30-year experience.
Laryngoscope. 2014 Oct; 124(10):2393-9.L

Abstract

OBJECTIVES/HYPOTHESIS

To characterize revision cochlear implant surgery and quantify rates of revision and device failure.

STUDY DESIGN

Retrospective review of 235 cases of revision cochlear implant surgery performed at the Sydney Cochlear Implant Center over a period of 30 years, between January 1982 and June 2011.

METHODS

Patient demographics and characteristics of revision surgery were retrospectively extracted from a centralized database. Analyses of overall and cumulative rates were performed.

RESULTS

During the study period, 2,827 primary cochlear implantations were performed in 2,311 patients, with 201 primary implants in 191 patients of this cohort (109 children and 82 adults) undergoing 235 revision surgeries. The most common indication for revision surgery was device failure (57.8%), followed by migration/extrusion (23.4%), infection/wound complication (17.0%), and poor outcome/secondary pathology (6.4%). The majority of revision surgeries were reimplantations. Overall revision and device failure rates were 8.3% and 4.8%, respectively. The cumulative revision rate for primary implants at all ages increased linearly by 1% per year. The cumulative revision rate was significantly higher in children, and decreased with more recently performed implantations and with newer generations of implants.

CONCLUSIONS

The cumulative revision rate for primary implants suggests an ongoing linear relationship between the time of postprimary implantation and the need for revision surgery. We have formed an evidence base that characterizes the nature and frequency of revision surgery in a high-volume setting, allowing clinicians to effectively counsel prospective patients and clinics to understand the burden of revision surgery and device failure.

Authors+Show Affiliations

Department of Otolaryngology, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24550135

Citation

Wang, Jeffrey T., et al. "Rates of Revision and Device Failure in Cochlear Implant Surgery: a 30-year Experience." The Laryngoscope, vol. 124, no. 10, 2014, pp. 2393-9.
Wang JT, Wang AY, Psarros C, et al. Rates of revision and device failure in cochlear implant surgery: a 30-year experience. Laryngoscope. 2014;124(10):2393-9.
Wang, J. T., Wang, A. Y., Psarros, C., & Da Cruz, M. (2014). Rates of revision and device failure in cochlear implant surgery: a 30-year experience. The Laryngoscope, 124(10), 2393-9. https://doi.org/10.1002/lary.24649
Wang JT, et al. Rates of Revision and Device Failure in Cochlear Implant Surgery: a 30-year Experience. Laryngoscope. 2014;124(10):2393-9. PubMed PMID: 24550135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rates of revision and device failure in cochlear implant surgery: a 30-year experience. AU - Wang,Jeffrey T, AU - Wang,Allen Y, AU - Psarros,Colleen, AU - Da Cruz,Melville, Y1 - 2014/04/02/ PY - 2013/10/24/received PY - 2014/01/19/revised PY - 2014/02/13/accepted PY - 2014/2/20/entrez PY - 2014/2/20/pubmed PY - 2014/12/15/medline KW - Cochlear implant KW - device failure KW - device failure rate KW - explantation KW - hard failure KW - reimplantation KW - revision rate KW - revision surgery KW - soft failure SP - 2393 EP - 9 JF - The Laryngoscope JO - Laryngoscope VL - 124 IS - 10 N2 - OBJECTIVES/HYPOTHESIS: To characterize revision cochlear implant surgery and quantify rates of revision and device failure. STUDY DESIGN: Retrospective review of 235 cases of revision cochlear implant surgery performed at the Sydney Cochlear Implant Center over a period of 30 years, between January 1982 and June 2011. METHODS: Patient demographics and characteristics of revision surgery were retrospectively extracted from a centralized database. Analyses of overall and cumulative rates were performed. RESULTS: During the study period, 2,827 primary cochlear implantations were performed in 2,311 patients, with 201 primary implants in 191 patients of this cohort (109 children and 82 adults) undergoing 235 revision surgeries. The most common indication for revision surgery was device failure (57.8%), followed by migration/extrusion (23.4%), infection/wound complication (17.0%), and poor outcome/secondary pathology (6.4%). The majority of revision surgeries were reimplantations. Overall revision and device failure rates were 8.3% and 4.8%, respectively. The cumulative revision rate for primary implants at all ages increased linearly by 1% per year. The cumulative revision rate was significantly higher in children, and decreased with more recently performed implantations and with newer generations of implants. CONCLUSIONS: The cumulative revision rate for primary implants suggests an ongoing linear relationship between the time of postprimary implantation and the need for revision surgery. We have formed an evidence base that characterizes the nature and frequency of revision surgery in a high-volume setting, allowing clinicians to effectively counsel prospective patients and clinics to understand the burden of revision surgery and device failure. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/24550135/Rates_of_revision_and_device_failure_in_cochlear_implant_surgery:_a_30_year_experience_ L2 - https://doi.org/10.1002/lary.24649 DB - PRIME DP - Unbound Medicine ER -