Intracranial complications of cochlear implantation.

OBJECTIVE

To describe intracranial complications after cochlear implantation in the pediatric and adult populations.

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary referral center.

PATIENTS

A chart review of the intracranial complications and their management in 345 patients undergoing cochlear implantation was undertaken.

INTERVENTIONS

Variables, including age, sex, implant manufacturer, cause of deafness, intraoperative findings, and postoperative complications, were collected and analyzed.

MAIN OUTCOME MEASURE

Presence of intracranial complication of cochlear implantation.

RESULTS

There were 134 Nucleus-22 (Cochlear, Englewood, CO) devices, 50 Nucleus-24 devices, 118 Med-El (Durham, NC) devices, and 43 Advanced Bionics Corporation (Sylmar, CA) devices in 151 adults and 194 children. There was a 9.3% overall complication rate, with most (59%) being related to device failure. There were three intracranial complications (<1%), two in elderly individuals and one in a child. Two minor dural defects with cerebrospinal fluid leak at the site of the receiver/stimulator recess in Med-El devices were repaired intraoperatively with temporalis fascia. One elderly patient experienced an acute extensive subdural hematoma after Nucleus-24 implantation, which was treated successfully with immediate evacuation.

CONCLUSION

Intracranial complication rates associated with cochlear implantation are low, although potentially very serious. Surgeons should be aware of intracranial complications, especially in older individuals, and take immediate appropriate action.