Download 13th International Conference on Cochlear Implants and Other

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Transcript
S32-5
Indications and outcome of cochlear reimplantation - 22 year review from the YorkshireAuditory Implant
Centre
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Raine C. , Martin J. , Totten C. , Strachan D. , Baren J.
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Yorkshire Auditory Implant Service, Bradford, United Kingdom
Objectives: Review of prospectively collected data of patients who had required revision surgery resulting in
reimplantation. To analyze demographics, causation and overall outcomes of safety and audiological
performance.
Methods: Evaluation of 67 re-implantations (23 adults/44 children) performed within 831 patients treated
between 1990-2012 at the Yorkshire Auditory Implant Service. Indications for initial surgery, surgical time
intervals for initial and reimplantation together with manufacturer failure analysis reports were reviewed. The later
information was used to classify the reason for failure. Results of audiological testing were recorded pre and post
re-implantation; Open-set sentence test scores BKB &CUNY were documented for adult patients, and CAP &
MAIS scores for children.
Results: Overall re-implantation rate was 8% (adult 6.5%/8% paed). Paediatric patients had a shorter time
interval between implantation and device failure (median time 1.98 v 3.76 years, P=0.019) and were more likely
to have a history of trauma (23.9% paed v 4.25% adults). Children with a history of trauma were younger at
device implantation (Median 2.36 v 3.16 years, P=0.019) and at the time of failure (Median age 3.94 v 5.61
years, P=0.007). All adults were classified C - device out of specification; Paediatric 76% C. 20% B2 & 4% D.
Open-set sentence tests improved in 16, CAP scores remained stable, or improved at 6/12. No complications
were encountered.
Conclusion: Results confirm that cochlear re-implantation is a safe procedure, and allows for continuing
auditory development in adults and children. Providers need to plan and budget for anticipated re-implantation
rate of up to 1% of their service provision per year.
Learning: Once a CI failure is recognized timely intervention is required especially with unilaterally implanted
patients.
There are no significant issues with re-implantation.
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