Cochlear implantation in infants: special surgical and medical aspects.

OBJECTIVE

To present medical and surgical aspects of cochlear implantation (CI) in infants and to compare the rate of complications of CI in infants with that of older children.

DESIGN

Retrospective study.

METHOD

Fifteen infants and 57 children aged 1 to 2 years at the time of CI with a follow-up of at least 12 months were studied.

RESULTS

Major complications (requiring explantation or revision surgery) occurred in 6.7% infants vs. 17.5% toddlers, P = .297. The rates for minor postoperative problems were 13.3% vs. 21.1%, respectively, P = .502. There were no incidents of surgery- or anesthesia-related complications in the present study. Device failure was found as a most common complication in older children (10.5%). Such patient-related complications as foreign body reaction, protrusion of the positioner and recurrent otitis media can result in device malfunction. Indeed, the rate of major complications supposed to increase with long-term follow-up.

CONCLUSIONS

The surgical procedure for CI in infants is feasible and patient-related complications are usually minor and may be managed conservatively. Because most postoperative major problems are implant-related, improving cochlear implant technology can enhance the reliability of the devices and prevent untoward events that need for explantations and reimplantations. To reduce the risk of general anesthesia in infants we recommended the presence of pediatric anesthesiologist at surgery. Shortening time of surgery with using of nonmastoidectomy techniques for CI can reduce the time of bacterial exposure of the wound and prevent surgical complications related to the facial nerve and chorda tympani damage as well as electrode misplacement.