One-time bilateral cochlear implantation: Is the blood loss tolerable for young patients?
23 April 2019 (online)
The care of young patients with bilateral deafness with cochlear implants has established itself as the standard procedure worldwide. The one-time bilateral cochlear implantation has been performed in many clinics for years without complications. Nevertheless, there are reasons listed to speak against a one-time care, especially the expected blood loss.
In a period of 3 years, a total of 32 children in the University Hospital Frankfurt am Main were treated with a cochlear implant on both sides. The preoperative hemoglobin (Hb) value was compared with the values after unilateral implantation.
It was found that a single-stage bilateral implantation was successfully performed on 25 children. In 7 children, the second side was implanted over time (21.8%). The mean preoperative Hb value was 11.84 g/dl. After the first implantation, the value was 10.52 g/dl (t-test: p = 0.001). If the blood loss was above this value (Hb < 10 g/dl), the immediate second implantation was defered. The average operation time of the bilateral implantation was 191 min.
In the case of one-step cochlear implantation, there is significant blood loss in the surgical treatment of the first side, but in more than 75% of cases, the second side can be treated in the same procedure. However, it remains an obligatory duty to control the loss of blood before the beginning of the other side.