Failure and Revision Surgery After Cochlear Implantation in the Adult Population

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eleanor Layfield ◽  
Tiffany Peng Hwa ◽  
James Naples ◽  
Ivy Maina ◽  
Jason A. Brant ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Cochlear Implantation ◽  
Adult Population

scholarly journals Comparison of Round Window Anatomy between Pediatric and Adult Population: A Perspective from Cochlear Implantation Surgery

2020 ◽  
Vol 42 (3) ◽  
pp. 23-25
Author(s):  
Rabindra B Pradhananga ◽  
Bigyan R Gyawali ◽  
Pabina Rayamajhi
Keyword(s):  
Cochlear Implantation ◽  
Adult Population ◽  
Round Window ◽  
Round Window Membrane ◽  
Institute Of Medicine ◽  
Statistical Association ◽  
Complex Anatomy ◽  
Wide Range ◽  
Posterior Tympanotomy ◽  
Round Window Niche

Introduction The round window is thought to be an ideal port for inserting electrodes during cochlear implantation. Considering its complex anatomy with an individual variation, this study aims to review the anatomy of round window based on the visibility of round window niche and round window membrane via posterior tympanotomy in pediatric and adult population who underwent cochlear implantation. MethodsThis was a retrospective observational study conducted at the Department of ENT-HNS, Institute of Medicine, Kathmandu, Nepal. Surgical notes of adult (>15 years) and pediatric cases (<15years) who underwent primary cochlear implantation from January 2015 to January 2018 were assessed for different grading of round window niche and round window membrane visibility via posterior tympanotomy. Cases with revision surgery and with incomplete documentation of intra-operative findings were excluded from the study. Statistical analysis was done using SPSS software version 25. We used Chi-square and Fisher’s exact tests to analyze the statistical association. ResultsType B round window niche (partially visible) was the most common variant seen in the pediatric group while in adults, both Type B (partially visible) and Type C (fully visible) round window niche were common. Compared to the adults, the pediatric group had good visibility of RWM. However, there was no statistical association between these observations. ConclusionThe round window has a wide range of anatomical variations with different levels of visibility of RWN and RWM in the different age groups. Although statistically insignificant, RWM visibility seemed to be better in pediatric cases compared to adults.

Subtotal petrosectomy and cochlear implantation: Revision surgery

2021 ◽  
pp. 103333
Author(s):  
Giovanni Pepe ◽  
Sebastiano Franzini ◽  
Maurizio Guida ◽  
Maurizio Falcioni
Keyword(s):  
Revision Surgery ◽  
Cochlear Implantation ◽  
Subtotal Petrosectomy

scholarly journals Management of delayed-onset skin flap complications after pediatric cochlear implantation

2020 ◽  
Author(s):  
Qingling Bi ◽  
Zhongyan Chen ◽  
Yong Lv ◽  
Jie Luo ◽  
Naya Wang ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Cochlear Implantation ◽  
Wound Closure ◽  
Wound Care ◽  
Skin Flap ◽  
Treatment Strategies ◽  
Clinical Situation ◽  
Delayed Onset ◽  
Reconstructive Option

Abstract Purpose To review delayed-onset skin flap complications associated with pediatric cochlear implantation (CI) in our institute, analyze the etiology, and explore effective treatment strategies. Methods Retrospective analyses of 811 children who had undergone cochlear implantation between January 2003 and March 2019 were performed. Twelve (1.48%) patients developed skin flap complications after CI. We present a classification of flap issues and wound histopathology following cochlear implantation. The interventions for flap problems included drug treatment, aspiration, local wound care, revision surgery, and explantation depending on the clinical situation. The temporalis myofascial reconstructive option is discussed. Results Seven subjects were cured with conservative treatment. Five cases with flap infection or necrosis underwent revision surgery, with wound closure in three cases (60%) and revision surgery with explantation in the remaining two cases (40%). Explantation ultimately led to wound healing in all cases. They all achieved excellent performance through re-implantation. Conclusion Flap complications after CI are rare but treatable. Comprehensive treatments should be developed to achieve a stable and healed wound for CI.

Audiological outcome of stapes surgery for far advanced cochlear otosclerosis

2017 ◽  
Vol 131 (11) ◽  
pp. 961-964 ◽  
Author(s):  
C Heining ◽  
R Banga ◽  
R Irving ◽  
C Coulson ◽  
P Monksfield
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Revision Surgery ◽  
Cochlear Implantation ◽  
Stapes Surgery ◽  
Hearing Thresholds ◽  
Suitable Treatment ◽  
Conductive Component ◽  
Clinically Significant ◽  
Hearing Outcomes

AbstractBackground:Patients with advanced otosclerosis can present with hearing thresholds eligible for cochlear implantation. This study sought to address whether stapes surgery in this patient group provides a clinically significant audiological benefit.Objectives:To assess pre- and post-operative hearing outcomes of patients with advanced otosclerosis, and to determine what proportion of these patients required further surgery including cochlear implantation.Methods:Between 2002 and 2015, 252 patients underwent primary stapes surgery at our institution. Twenty-eight ears in 25 patients were deemed to have advanced otosclerosis, as defined by pure audiometry thresholds over 80 dB. The patients’ records were analysed to determine audiological improvement following stapes surgery, and assess whether any further surgery was required.Results:The audiological outcome for most patients who underwent primary stapes surgery was good. A minority of patients (7 per cent) required revision surgery. Patients who underwent cochlear implantation after stapes surgery (10 per cent) also demonstrated a good audiological outcome.Conclusion:Stapes surgery is a suitable treatment option for patients with advanced otosclerosis, and should be considered mandatory, before offering cochlear implantation, for those with a demonstrable conductive component to their hearing loss. A small group of patients get little benefit from surgery and subsequently a cochlear implant should be considered.

Increased incidence of anterior cruciate ligament revision surgery in paediatric verses adult population

2017 ◽  
Vol 26 (5) ◽  
pp. 1362-1366 ◽  
Author(s):  
Diego Costa Astur ◽  
Charles Marcon Cachoeira ◽  
Tierri da Silva Vieira ◽  
Pedro Debieux ◽  
Camila Cohen Kaleka ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Adult Population ◽  
Anterior Cruciate

scholarly journals Correlation between behaviorally measured comfort (c) levels and electrically evoked stapedius reflex thresholds (ESRT) in children with unilateral cochlear implant

2019 ◽  
Vol 11 (4) ◽  
pp. 201-206
Author(s):  
Roshani Mishra ◽  
Aparna Nandurkar
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Pediatric Population ◽  
Adult Population ◽  
Age Groups ◽  
Acoustic Stimulation ◽  
Comfort Level ◽  
Clear Cut ◽  
Significant Difference ◽  
Stapedius Reflex

Introduction: Decrease in the lower age limit for paediatric cochlear implantation and increasing records of cochlear implantation in children with associated impairments demand quick and easily available objective measurements to provide MAP in these children as their speech and language ability may not be adequate to provide clear cut explanation about comfort level. Providing adequate amount of acoustic stimulation in this golden period of life (i.e. 0-2 years) is important in ensuring the proper utilization of acoustic cues. Findings of adult population cannot be directly applied to younger children and till date there is no Indian study reporting relationship between Electrically Evoked Stapedial Reflex Thresholds (ESRT) and behavioural Comfort levels, especially in pediatric population. Aim: The present study aimed to assess the correlation between behaviorally measured comfort (C) levels and Electrically Evoked Stapedius Reflex Thresholds (ESRT) in children with unilateral cochlear implant. Method: Children (n=40) with age range of 4-12 years, who received the same type of CI and electrode configuration, were selected for the study. Participants were divided into two groups – younger and older - based on their chronological age. Behavioural C-level measurement and ESRT measurement were done after tympanometry for both the groups. Correlation between the two measures was obtained and comparison between the two groups was done. Results and discussion: Recorded ESRT was consistently higher than the behaviorally obtained C-level for both the groups. The correlation between ESRT and C-level varies from moderate to very strong and strong to very strong for the younger and older groups respectively. No statistically significant difference was found between the correlations for the two age groups. Conclusions: High correlations were found between the ESRT and behaviorally obtained C-levels. Thus ESRT can be utilized as a tool for programming in younger implant recipients.

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