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Cochlear implantation under local anesthesia and conscious sedation: an Italian experience

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To report our experience in performing cochlear implantation under local anesthesia in a group of patients who were deemed unfit for general anesthesia.

Methods

A retrospective chart review was performed to analyze undesirable events and any other discomfort complained by patients during cochlear implantation. Analysis of patient’s satisfaction was performed by means of a survey instrument. We have also compared the duration of surgery and hospitalization time with a control group that was implanted under general anesthesia.

Result

Twenty-one cochlear implantation in 20 patients were performed under local anesthesia. Age of patients ranged from 38 to 85 years. All interventions were successfully completed without any conversions to general anesthesia. Discomfort during surgery was reported in five cases: vertigo triggered by electrode insertion in two patients, pain during the round window approach in two patients and distress during the use of drill in one case; no patient experienced agitation. During the postoperative period, no complications or unpleasant experiences were reported. Only two patients stated that they would not perform cochlear implantation again under local anesthesia. Lower duration surgery and hospitalization time were found in the local anesthesia group.

Conclusion

Local anesthesia with conscious sedation is a safe and effective alternative for cochlear implant candidates considered unfit for general anesthesia. Fundamental for a successful procedure are preoperative counselling, accurate selection of the patients and constant intraoperative assistance. Unfeasibility of facial nerve monitoring and minor detrimental effect on training are the principal disadvantages in performing cochlear implantation under local anesthesia.

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Authors and Affiliations

  1. Department of Otolaryngology and Otoneurosurgery, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy

    Vincenzo Vincenti, Giovanni Ciavarro, Francesca Lusetti & Filippo Di Lella

  2. Otolaryngology Unit, Section of Otologic and Neurotologic Surgery, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy

    Francesca Plantone, Roberto Bartoli, Maria Luisa Fiorella & Nicola Quaranta

  3. Otorhinolaryngology Department, Ramazzini Hospital, Carpi, Italy

    Maurizio Negri

Authors
  1. Vincenzo Vincenti
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  2. Francesca Plantone
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  3. Giovanni Ciavarro
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  4. Francesca Lusetti
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  5. Roberto Bartoli
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  6. Filippo Di Lella
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  7. Maurizio Negri
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  8. Maria Luisa Fiorella
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  9. Nicola Quaranta
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Corresponding author

Correspondence to Giovanni Ciavarro.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No animals are involved.

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Vincenti, V., Plantone, F., Ciavarro, G. et al. Cochlear implantation under local anesthesia and conscious sedation: an Italian experience. Eur Arch Otorhinolaryngol 278, 3667–3672 (2021). https://doi.org/10.1007/s00405-020-06419-4

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  • DOI: https://doi.org/10.1007/s00405-020-06419-4

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