Wijaya C, Simões-Franklin C, Glynn F, Walshe P, Reilly R, Viani L
National Hearing Implant Research Centre, Beaumont Hospital , Dublin 9 , Ireland.
Royal College of Surgeons in Ireland , Dublin 2 , Ireland.
Cochlear Implants Int. 2019 Nov;20(6):281-287. doi: 10.1080/14670100.2019.1647372. Epub 2019 Aug 1.
To report a long-term experience on revision cochlear implantation (RCI) in a single institution, categorize their indications and to identify predictive parameters of implant failure. A retrospective study was conducted on a prospective database of a national cochlear implant unit. Patients requiring RCI between January 1995 and June 2016 were identified and stratified into adult and paediatric group. Medical records, investigation reports and device analysis reports were reviewed and analysed. A total of 37 children and 21 adults were identified requiring RCI on 60 devices. 63.3% of the RCI was indicated due to the device failure, while 36.7% was due to various medical reasons. Higher device failure rate was reported in the paediatric group, due to the high number of direct head trauma, which was not observed in the adult group. The leading medical indication for RCI was due to wound infection (10%). The overall RCI rate was 5.0%, among which 3.1% was due to device failures. A brief discussion on various medical indications, surgical challenges, and the mechanism of thought process to consider RCI, including treatment planning was outlined. RCI in the paediatric population poses a unique challenge. Integrity testing is helpful in identifying a potential device malfunction; however, regular clinical follow-up with multidisciplinary assessments is invaluable in the decision process for RCI.
报告单一机构中人工耳蜗翻修术(RCI)的长期经验,对其适应证进行分类,并确定植入失败的预测参数。对国家人工耳蜗植入单位的前瞻性数据库进行了一项回顾性研究。确定了1995年1月至2016年6月期间需要进行RCI的患者,并将其分为成人组和儿童组。对病历、检查报告和设备分析报告进行了审查和分析。共确定37名儿童和21名成人需要对60台设备进行RCI。63.3%的RCI是由于设备故障,而36.7%是由于各种医学原因。儿童组的设备故障率较高,原因是直接头部外伤的数量较多,而成人组未观察到这种情况。RCI的主要医学适应证是伤口感染(10%)。总体RCI率为5.0%,其中3.1%是由于设备故障。概述了对各种医学适应证、手术挑战以及考虑RCI的思维过程机制(包括治疗计划)的简要讨论。儿童人群中的RCI带来了独特的挑战。完整性测试有助于识别潜在的设备故障;然而,在RCI的决策过程中,定期进行多学科评估的临床随访非常宝贵。