Pediatric cochlear reimplantation: Decision-tree efficacy

The context leading to pediatric cochlear reimplantation (CreI) can be complex. The objectives of this study were to define initial CreI indications, analyze final diagnosis and draw up a decision-tree. A retrospective study included patients undergoing CreI between 2005 and 2015. Demographic charac...

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Bibliographic Details
Published in:European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2018-08, Vol.135 (4), p.243-247
Main Authors: Distinguin, L., Blanchard, M., Rouillon, I., Parodi, M., Loundon, N.
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Children
Cochlear implant
Cochlear Implantation
Complication
Decision Trees
Device failure
Humans
Infant
Prosthesis Failure
Reimplantation
Reoperation
Retrospective Studies
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Summary:The context leading to pediatric cochlear reimplantation (CreI) can be complex. The objectives of this study were to define initial CreI indications, analyze final diagnosis and draw up a decision-tree. A retrospective study included patients undergoing CreI between 2005 and 2015. Demographic characteristics, CreI circumstances and technical reports were collected. Circumstances indicating CreI were classified in 3 groups: performance decrement, suspected device failure, or medical. After CreI, final diagnoses were classified in 2 groups: confirmed failure (DFail) or medical (DMed). 69 out of 734 cochlear implantation surgeries were for CreI (8%). Manufacturers’ reports were available in 64 cases (93%). Two principal causes were found: trauma and infection. Initial indications were: performance decrement: 27%; device failure: 56%; and medical: 17%. Final diagnoses were: DFail: 72%; and DMed: 28%. Initial indication and final diagnosis were similar in 86% of cases. The majority of the 14% initial indication errors belonged to the “performance decrement” group. Traumatic causes correlated with risk of initial indication error (P=0.039). Apart from spontaneous device failure, the two causes of CreI were infection and trauma. Using the present decision algorithm, half of the complex cases were resolved after CreI.
ISSN:1879-7296
1879-730X
DOI:10.1016/j.anorl.2018.05.002