Retrospective Analysis Of Patients Undergoing Reoperation After Cochlear Implantation

Background and ObjectiveCochlear implantation has become the main treatment of severe and extremely severe sensorineural deafness,and the incidence of postoperative complications is low,with high safety.However,cochlear implants are expensive and the expectations of patients and their families are high.Once complications occur after operation,especially those that require surgery to achieve the goal of cure,it will bring heavy psychological and economic burden to patients and families.Based on this,the purpose of this study is to analyze the clinical characteristics and causes of reoperation after cochlear implantation,so as to reduce the incidence of such complications,and explore the best treatment options to provide reference for future clinical treatment.MethodsA retrospective study was conducted to analyze the case information of 1693 patients who underwent cochlear implantation in our department from January 2009 to December 2017.Of these patients,34 underwent reoperation due to various postoperative complications.Among 34 patients,22 were males and 12 were females;23 were right ears and 11 were left ears;30 were minors and 4 were adults;the youngest was 1.3 years old and the oldest was 53.5 years old at the time of reoperation;10 were urban patients and 24 were rural patients;the interval between reoperation and cochlear implantation was the shortest of 4 days,the longest of 3219 days,with an average of 720 days and the median of 335.5 days.The population characteristics,causes of reoperation,treatment methods and prognosis of 34 patients were analyzed.ResultsThe causes and distribution of reoperation in 34 patients were as follows: subcutaneous effusion and infection in 12 cases,skin flap infection and necrosis in 4 cases,implant displacement in 7 cases,cochlear damage and failure in 5 cases,damage of posterior wall of external auditory canal in 2 cases,cerebrospinal fluid otorrhea in 2 cases,ectopic implantation in 1 case,and rejection in 1 case.All 34 patients underwent surgical treatment.A total of 20 patients retained cochlear implants and 14 patients removed cochlear implants(including 12 new cochlear implants: 7 ipsilateral implants and 5 contralateral implants).After cochlear implantation,the function of cochlear implant was normal,the incision recovered well,the new cochlear implant worked well after the start-up,and the patients who removed the cochlear implant recovered well.Conclusion1.The incidence of reoperation after cochlear implantation is low,it is only 2.01% in this study.2.The causes of reoperation can be summarized as self-factors of patients,implant factors and cochlear implant surgery factors.In order to reduce the incidence of reoperation,preventive measures can be taken from the above factors.3.Symptomatic surgical treatment and etiological treatment are the main methods of the complications needing reoperation,but there is still no consensus on the treatment of some complications,it needs a lot of clinical practice and exploration in the future.