Kalaycik Ertugay Cigdem, Yigit Ozgur, Akı Ecem Sevim
Department of Otorhinolaryngology/Head and Neck Surgery, Kozyatagı Acıbadem Hospital, Istanbul, Turkey.
Department of Otorhinolaryngology/Head and Neck Surgery, University of Health Sciences Istanbul Education and Research Hospital, Istanbul, Turkey.
Iran J Otorhinolaryngol. 2025;37(3):143-150. doi: 10.22038/ijorl.2025.77740.3612.
We aimed to report our clinic's 11-year experience with cochlear implant (CI) revision surgeries.
This was a retrospective observational study. Patients who underwent CI and revision surgery at the same tertiary institution were enrolled in the study. Patients whose primary surgery was performed at another institution were excluded from the study. The patients' clinical charts, surgical records, and audiological and oral language outcomes were retrospectively examined.
Thirty-three (29 children, 4 adults) of 720 patients (871 CI) at our clinic required revision surgery, representing a revision surgery rate of 4.58%. The most common reason for revision was device failure (10 patients), followed by skin and electrode problems, with electrode tip fold-over in 6 patients, a broken electrode cable in 1 patient, skin flap complications in 6 patients, displacement of the magnet in 1 patient, cholesteatoma in 1 patient, electrode migration in 6 patients, misplacement of the electrode array into the internal acoustic canal in 1 patient, and explantation of the electrode cable in the external auditory canal in 1 patient. We had only one major complication after revision surgery.
We recommend performing routine postoperative imaging, even if intraoperative telemetries are normal, to diagnose electrode misplacement or electrode tip fold-over. Additionally, we recommend long-term regular follow-up of children, in particular, because our study showed that the number of revision surgeries was higher in children who received implants at an early age.
我们旨在报告我们诊所11年来进行人工耳蜗(CI)翻修手术的经验。
这是一项回顾性观察研究。在同一三级医疗机构接受CI和翻修手术的患者被纳入研究。初次手术在其他机构进行的患者被排除在研究之外。对患者的临床病历、手术记录以及听力和口语语言结果进行了回顾性检查。
我们诊所720例患者(871个CI)中有33例(29名儿童,4名成人)需要进行翻修手术,翻修手术率为4.58%。翻修的最常见原因是设备故障(10例患者),其次是皮肤和电极问题,其中电极尖端折叠6例,电极电缆断裂1例,皮瓣并发症6例,磁体移位1例,胆脂瘤1例,电极移位6例,电极阵列误置入内耳道1例,外耳道电极电缆取出1例。翻修手术后我们仅出现一例严重并发症。
我们建议即使术中遥测正常,也应进行常规术后影像学检查,以诊断电极误置或电极尖端折叠。此外,我们建议对儿童进行长期定期随访,特别是因为我们的研究表明,早期接受植入的儿童翻修手术的数量更高。