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Risk factors for complications in cochlear implant surgery

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

Abstract

Purpose

The objective of this study was to achieve uniform reporting of complications and failures in cochlear implantation, to analyze complications and failures and to identify risk factors for complications in a series of over 1300 cochlear implantations.

Methods

In a retrospective chart review and observational study, data from all cochlear implantations from 1987 to 2015 were entered in a custom-made database. Complications were classified using the contracted form of the Clavien–Dindo system and risk factors were identified by statistical analysis.

Results

A complication rate of 18.4% and a device failure rate of 2.9% were found. There was a higher rate of hematoma in patients with a clotting disorder and when a subtotal petrosectomy was performed, a higher rate of wound infections in patients who were not vaccinated against Streptococcus pneumoniae and a higher rate of meningitis in patients with an inner ear malformation.

Conclusions

The use of a strict definition of a medical complication and device failure—in combination with the Clavien–Dindo classification system—enables uniform and objective registration of adverse events and prevents any tendency to downgrade complications. Complication and failure rates in this series are comparable to those reported in the literature. These results stress the need for pneumococcal vaccination, which may prevent general wound infections, but is especially important for patients with inner ear malformation, who have an increased risk of (postoperative) meningitis.

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Acknowledgements

The authors thank Ms E. Dekkers for assistance with the data collection.

Funding

Cochlear Europe Ltd financially supported this study.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands

    Henricus J. Theunisse

  2. Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

    Henricus J. Theunisse, Ronald J. E. Pennings, Henricus P. M. Kunst, Jef J. Mulder & Emmanuel A. M. Mylanus

  3. Centre for Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands

    Henricus J. Theunisse, Ronald J. E. Pennings, Jef J. Mulder & Emmanuel A. M. Mylanus

  4. Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands

    Henricus P. M. Kunst

Authors
  1. Henricus J. Theunisse
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  2. Ronald J. E. Pennings
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  3. Henricus P. M. Kunst
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  4. Jef J. Mulder
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  5. Emmanuel A. M. Mylanus
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Corresponding author

Correspondence to Henricus J. Theunisse.

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Conflict of interest

Authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies 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. For this type of study formal consent is not required.

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Theunisse, H.J., Pennings, R.J.E., Kunst, H.P.M. et al. Risk factors for complications in cochlear implant surgery. Eur Arch Otorhinolaryngol 275, 895–903 (2018). https://doi.org/10.1007/s00405-018-4901-z

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  • DOI: https://doi.org/10.1007/s00405-018-4901-z

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