Cisneros-Lesser JC, Carrillo-Soto IA, Hernández-Palestina MS

Language: Spanish
References: 15
Page: 237-247
PDF size: 653.47 Kb.

ABSTRACT

Background: The application of a cochlear implant is a safe procedure eventhough it has a variable range of complications. Major and minor complications can happen in 2.1 to 11.7% of cases and 5.8 a 25.4% respectively acording to diferent series. Cochlear implantation is becoming more available every day as a treatment for bilateral profound deaffness in Mexico.
Objective: To analyze the complications found during trans and postoperatory periods in pediatric patients who underwent cochlear implantation in a single tertiary referral center.
Material and method: A retrospective analysis of treatment and evolution of short- and long-term complications of the cochlear implantation to 50 pediatric patients was done. The mean age at implantation was of 3.1 years, ranging from 1.6 to 7.8 years. Of these children, 22 (44%) had congenital deafness of unknown cause. The most common suspected causes were neonatal anoxia (n = 6, 12%) and aminoglycoside use in the first months of life (n = 6, 12%) followed by congenital cytomegalovirus infection (n = 3, 6%). The mean follow-up at the time of the study was 22 months (range, 6-48 months).
Results: There were a total of 16 adverse events (32% in 50 patients) considered complications throughout the follow-up of these 50 patients. There was one major perioperative complication (2%) and 5 minor complications in the same period (10%). In the early postoperative period there was one major complication (2%) and one minor complication (2%) and in the late postoperative there were 4 major (8%) and 4 minor (8%) complications. Minor complications (e.g., eardrum perforation, hematoma, flap swelling, wound infection, temporary facial weakness) settled with conservative treatment or minor intervention. With regard to the major complications, these included a patient whose facial nerve was damaged during mastoidectomy, 2 patients with a tympanic perforation in the implanted ear secondary to acute suppurative otitis media in the postoperative period, a patient who developed a postauricular abscess after head trauma directly at the stimulator-receptor site, one patient who suffered a head trauma with irreparable damage to the receptor-stimulator, and a patient who developed an acute mastoiditis in the mastoid cavity of a previously implanted ear.
Conclusions: Cochlear implantation is a relatively safe surgical procedure. Most surgical complications after cochlear implantation are minor and can be managed with conservative treatment or minor surgical intervention. However, an adequate preparation of the patient before surgery, meticulous attention to surgical detail and a long-term follow-up are of paramount importance in minimizing the incidence of surgical and infectious complications in implanted pediatric patients.

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