Comparison of Adult and Pediatric Cochlear Implant Wound Complications: A Meta‐Analysis

• Published in: The Laryngoscope 2023-02, Vol.133 (2), p.218-226
• Main Authors: Ekman, Brady, Laureano, Jack, Balasuriya, Beverly, Mahairas, Anthony, Bush, Matthew L.
• Format: Article
• Language: English
• Subjects: Adult; Adults; Age Distribution; Aged; Child; cochlear implantation; Cochlear Implantation - adverse effects; Cochlear implants; Humans; Laryngoscopy; Meta-analysis; Pediatrics; Surgical Wound Infection - epidemiology; systematic review; wound complications
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.30168

Objective To compare age‐related differences in wound complications following cochlear implantation (CI). Methods We performed a systematic review of PubMed, Cochrane Database, and Web of Science databases to identify original research evaluating the patient‐level factors (demographics and medical history) associated with wound complications following CI. Outcomes were expressed as relative risk (RR) with 95% confidence intervals using the inverse variance method. Studies without comparison groups were described qualitatively. Results Thirty‐eight studies representing 21,838 cochlear implantations were included. The rate of wound complications ranges from 0% to 22%. Patient age (adult versus pediatric) was the only factor with comparison groups appropriate for meta‐analysis. The 10 studies (n = 9547 CI's) included in the meta‐analysis demonstrated that adults had a higher incidence of overall wound complications (2.94%) than in children (2.44%) (RR 1.31, 95% CI 1.01–1.69). Adults had a higher incidence of general/unclassified wound complications (2.07%) than in children (1.34%) (RR 1.68, 95% CI 1.12–2.52). There was no difference between adults and children for specific complications such as hematoma, infection, or seroma. Elderly patients (over age 75) have wound complication rates that range from 1% to 4%. No studies contained comparison groups regarding other patient‐level factors and CI wound complications. Conclusion CI wound complication rates reported in the literature are low; however, adults have a higher risk of these complications than pediatric patients. The reported complication rate in elderly adults is low. There is a gap in CI research in consistently reporting wound complications and rigorous research investigating the impact of patient‐level factors and wound complications. Level of Evidence NA Laryngoscope, 133:218–226, 2023 The objective of this study is to compare age‐related differences in wound complications following cochlear implantation (CI). CI wound complication rates reported in the literature are low; however, adults have a higher risk of these complications than pediatric patients. The reported complication rate in elderly adults is low.