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Vol. 66. Issue 6.
Pages 342-347 (November - December 2015)
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Vol. 66. Issue 6.
Pages 342-347 (November - December 2015)
Original article
DOI: 10.1016/j.otoeng.2014.11.005
Experience in Cochlear Reimplantation. Descriptive Study of a 20-Year Period
Experiencia en reimplantación coclear. Estudio descriptivo durante un período de 20 años
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Andrés Gutiérrez-Salazar
Corresponding author
andresgut86@gmail.com

Corresponding author.
, Constanze Cop, Ángel Osorio-Acosta, Silvia Borkoski-Barreiro, Juan C. Falcón-González, Ángel Ramos-Macías
Departamento de Otorrinolaringología y Patología Cérvico-Facial, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain
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Tables (4)
Table 1. Information About the Patients Treated by Surgery to Repeat Cochlear Implant.
Table 2. Causes of Hearing Loss According to Age.
Table 3. Number of Reimplantations Due to Device Failure and Time Between the First and Second Implant (in Months).
Table 4. European Consensus Statement on Cochlea Implant Faults and Explants, 2005 (ECSCIFE).
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Abstract
Introduction and objectives

The cochlear implant is a surgical procedure that has increased substantially, because the paediatric population is diagnosed and implanted early and because there are increased potential indications. This device has the inherent risk of failure in performance, as dies any active medical device, which is the most common cause of implant removal. Our goal was to understand what the causes that produced removal in our series were, and confirm if these conformed to reality as reviewed in the literature.

Methods

This was a retrospective, descriptive, observational study of 859 cochlear implant surgeries carried out between October 1991 and May 2011. The causes of implant removal were classified according to the European Consensus Statement on Cochlear Implant Failures and Explantations.

Results

The reimplantation rate was 6.16% (n=51). The most common reason for removal was technical device failure (45.5%), followed by infection/rejection (23.6%) and upgrade (12.7%). Less common causes: there were 3 cases (5.6%) of electrode misplacement, 2 cases (3.6%) of labyrinthine ossification, 2 (3.6%) as a result of head trauma, 2 (3.6%) from need for nuclear magnetic resonance imaging and 1 case (1.8%) from psychiatric illness.

Conclusions

Cochlear reimplantation is a safe procedure, with a low complication rate. In our centre, it reaches an overall rate of 6.16%. Technical device failure remains the most common cause of this procedure, although there is a significant percentage of reimplantation for device update

Keywords:
Cochlear implants
Complications
Hearing loss sensorineural
Resumen
Introducción y objetivos

El implante coclear es un procedimiento quirúrgico que ha presentado un incremento sustancial, debido a que la población pediátrica es diagnosticada e implantada de forma temprana y al incremento de indicaciones posibles. Este dispositivo tiene el riesgo inherente de presentar fallos en su funcionamiento, siendo esta la causa más frecuente de explantación. Nuestro objetivo es conocer las causas que en nuestra serie nos han llevado a ello y confirmar si se ajusta a la realidad según lo revisado en la literatura médica.

Métodos

Estudio retrospectivo observacional y descriptivo de 859 cirugías de implante coclear, realizadas entre octubre de 1991 y mayo de 2011. Las causas de explantación fueron clasificadas según el Consenso Europeo de Fallos y Explantaciones de los Implantes Cocleares.

Resultados

La tasa de reimplantación fue de 6,16% (n=51). La causa más frecuente de explantación fue el fallo técnico del dispositivo (45,5%), seguida de infección/rechazo del implante (23,6%) y actualización del mismo (12,7%). Entre las causas menos frecuentes se encontraron 3 casos (5,6%) por malinserción de los electrodos, 2 casos (3,6%) de fallo por osificación, 2 (3,6%) por traumatismo craneoencefálico, 2 (3,6%) por realización de resonancia nuclear magnética y un caso (1,8%) por enfermedad psiquiátrica.

Conclusiones

La reimplantación coclear es un procedimiento seguro, que presenta una baja tasa de complicaciones. En nuestro centro alcanza una tasa global de 6,16%. El fallo técnico del dispositivo sigue siendo la causa más frecuente de este procedimiento, con un importante porcentaje de reimplantes por actualización del dispositivo.

Palabras clave:
Implante coclear
Complicaciones
Hipoacusia neurosensorial

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