Introduction: As the cochlear implant (CI) surgeries are on rise, there is a compelling need to
understand its long-term complications and revision surgery protocols. Our experience
in the management of CI devices failure is shared in this paper. Aim: To review the
experience in patients who underwent CI device manipulation/explanation in terms of
failure rate, etiology, surgical considerations, and preoperative and postoperative
auditory and speech outcome. Study Design: This was a retrospective study. Materials and Methods: A retrospective study of 250 patients (201 children and 49 adults) with normal cochlea
at a tertiary care center from June 2004 to June 2014 was done. All cases were implanted
multichannel devices via Veria technique of CI surgery. Preoperative assessment, surgical
considerations, and postoperative auditory and speech outcomes were analyzed. Preoperative
and postoperative auditory/speech outcomes were analyzed using Category of Auditory
Perception (CAP) and Speech Intelligibility Rating (SIR) scores. Results: Reimplantation rate was 4%. The causes of revision CI surgery were hard device failure
(n = 3), surgical site infection (n = 3), magnet displacement (n = 2), and electrode
extrusion (n = 2). In one patient, recurrent cutaneous infection on the implanted
site ultimately resulted in reimplantation in the opposite ear after multiple surgical
interventions on the same side. The preoperative and postoperative CAP and SIR scores
showed improvement in the postoperative period with P < 0.05 as compared with the
paired t- test. Conclusions: Preoperative counseling for device failure should always be emphasized. The success
rate is high in revision surgery with good performance in the postoperative audiological
outcome. There is a compelling need for an agreed international definition of CI failure
and the adoption of uniform reporting protocols.
Key-words:
Category of Auditory Perception score - cochlear implant device failure - reimplantation
protocol - Speech Intelligibility Rating score - surgical considerations
