Deep Nicholas L, Purcell Patricia L, Gordon Karen A, Papsin Blake C, Roland J Thomas, Waltzman Susan B
Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York City, United States.
Department of Otolaryngology, Head & Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Trends Hear. 2021 Jan-Dec;25:23312165211014695. doi: 10.1177/23312165211014695.
The aim of this study was to investigate surgical, anesthetic, and device-related complications associated with cochlear implantation (CI) in children younger than 1 year of age. This was a multicenter, retrospective chart review of all children with severe-to-profound sensorineural hearing loss who underwent cochlear implantation with a Cochlear Nucleus Implant System before 1 year of age. Endpoints included perioperative course, major and minor surgical, anesthetic and device-related complications, and 30-day readmission rates. One hundred thirty-six infants (242 ears) met criteria. The mean age at implantation was 9.4 months (standard deviation 1.8). Six-month follow-up was reported in all patients. There were no major anesthetic or device-related complications. Adverse events were reported in 34 of implanted ears (14%; 7 major, 27 minor). Sixteen adverse events occurred ≤30 days of surgery, and 18 occurred >30 days of surgery. The 30-day readmission rate was 1.5%. The rate of adverse events did not correlate with preexisting medical comorbidities or duration under anesthesia. There was no significant difference detected in complication rate for patients younger than 9 months of age versus those 9 to 11 months of age. This study demonstrates the safety of CI surgery in infants and supports reducing the indication for cochlear implantation to younger than 1 year of age for children with bilateral, profound sensorineural hearing loss obtaining a Cochlear Nucleus Implant System.
本研究的目的是调查1岁以下儿童人工耳蜗植入(CI)相关的手术、麻醉和设备并发症。这是一项多中心回顾性图表审查,对象为所有在1岁前接受科利耳核植入系统人工耳蜗植入的重度至极重度感音神经性听力损失儿童。观察指标包括围手术期过程、主要和次要的手术、麻醉及设备相关并发症,以及30天再入院率。136名婴儿(242耳)符合标准。植入时的平均年龄为9.4个月(标准差1.8)。所有患者均报告了6个月的随访情况。未发生重大麻醉或设备相关并发症。34只植入耳(14%;7例主要,27例次要)报告了不良事件。16例不良事件发生在手术后≤30天,18例发生在手术后>30天。30天再入院率为1.5%。不良事件发生率与术前合并症或麻醉时间无关。9个月以下患者与9至11个月患者的并发症发生率无显著差异。本研究证明了婴儿人工耳蜗植入手术的安全性,并支持将双侧重度感音神经性听力损失且接受科利耳核植入系统的儿童人工耳蜗植入适应症降低至1岁以下。