婴儿在 9 个月和 12 个月之前以及年龄较大的儿童接受手术、麻醉和器械相关并发症的发生率：儿科人工耳蜗植入候选标准不断扩大的证据。

Prevalence of Surgical, Anesthetic, and Device-related Complications Among Infants Implanted Before 9 and 12 Months of Age Versus Older Children: Evidence for the Continued Expansion of Pediatric Cochlear Implant Candidacy Criteria.

机构信息

Mayo Clinic Alix School of Medicine.

Department of Otolaryngology-Head and Neck Surgery.

出版信息

Otol Neurotol. 2021 Jul 1;42(6):e666-e674. doi: 10.1097/MAO.0000000000003060.

DOI:10.1097/MAO.0000000000003060

PMID:33710142

Abstract

OBJECTIVE

To compare the prevalence of surgical, anesthetic, and device-related complications among infants and older children receiving cochlear implantation (CI).

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary academic referral center.

PATIENTS

Pediatric patients who underwent CI from November 1990 to January 2020.

INTERVENTION

CI.

MAIN OUTCOME MEASURES

Surgical, anesthetic, and device-related complication rates were compared by age group (<12 versus 12-23 versus 24+ months with subset analysis of <9 versus 9-11 months).

RESULTS

A total of 406 primary pediatric CI surgeries encompassing 482 ears were analyzed, including 45 ears in 23 patients implanted less than 9 months and 89 ears in 49 patients less than 12 months. No anesthetic complications occurred. Postoperative surgical and device-related complication rates were not significantly different among the less than 12, 12 to 23, and 24+ month groups (16% versus 16% versus 12%; p = 0.23) or between the less than 9 and 9 to 11 month groups (22% versus 9%; p = 0.09). Thirty-day readmission was significantly higher for patients less than 12 months compared with patients 24+ months (6% versus <1%; p = 0.011), but was not significantly higher compared with patients 12 to 23 months (6% versus 3%; p = 0.65). Reoperation rates did not differ significantly among the less than 12, 12 to 23, and 24+ month groups (10% versus 7% versus 6%; p = 0.31).

CONCLUSIONS

The prevalence of surgical, anesthetic, and device related complications was not significantly different among infants implanted less than 9 or less than 12 months of age when compared with older children. These data provide evidence for the continued expansion of pediatric cochlear implant candidacy criteria to include appropriately selected infants less than 9 months of age.

摘要

目的

比较婴儿和大龄儿童接受人工耳蜗植入（CI）的手术、麻醉和器械相关并发症的发生率。

研究设计

回顾性病历分析。

设置

三级学术转诊中心。

患者

1990 年 11 月至 2020 年 1 月期间接受 CI 的儿科患者。

干预措施

CI。

主要观察指标

通过年龄组（<12 个月、12-23 个月和 24+个月，<9 个月和 9-11 个月亚组分析）比较手术、麻醉和器械相关并发症的发生率。

结果

共分析了 406 例原发性儿科 CI 手术，共 482 耳，包括 23 例患者的 45 耳植入时间<9 个月和 49 例患者的 89 耳植入时间<12 个月。未发生麻醉并发症。<12 个月、12-23 个月和 24+个月组之间，以及<9 个月和 9-11 个月组之间，术后手术和器械相关并发症的发生率无显著差异（16%比 16%比 12%；p=0.23）或<12 个月和 24+个月组之间（6%比<1%；p=0.011）。与 24+个月的患者相比，<12 个月的患者 30 天内再入院率显著更高（6%比<1%；p=0.011），但与 12-23 个月的患者相比，差异无统计学意义（6%比 3%；p=0.65）。<12 个月、12-23 个月和 24+个月组之间的再次手术率无显著差异（10%比 7%比 6%；p=0.31）。