Learning Objectives: This study documented the incidence of complications and revisions following CI and analyze causes and management outcomes in order to understand what could be learned from the experiences of revision CI surgery.
Introduction: Complications of Cochlear implantation (CI) sometimes lead to revision surgeries or even reimplantation. However, the auditory performance and speech intelligibility subsequent to reimplantation are not often discussed, especially in Mandarin-speaking users. This study review our experience with CI surgeries in Mandarin speaking users over a 16-year period, emphasizing causes, auditory performance, and speech intelligibility after reimplantation.
Methods: 589 patients who underwent CI in our medical center between 1999 and 2014 were reviewed retrospectively. Data related to demographics, etiologies, implant-related information, complications, and hearing and speech performance were collected.
Results: 22 (3.74%) cases were found to have major complications. Infection (n = 12) and hard failure of the device (n = 8) were the most common major complications. The incidence of minor complications was 11.04% (n = 65). In total, 18 (3.06%) patients underwent revision surgeries due to infection (n = 9), device failure (n = 8), and severe hematoma (n = 1). Among them, 13 were reimplanted in our hospital. The mean scores of the Categorical Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) obtained before and after reimplantation were 5.5 versus 5.8 and 3.7 versus 4.3, respectively. The SIR score after reimplantation was significantly better than pre-operation.
Conclusion: The Mandarin-speaking patients who received reimplantation had restored auditory performance and speech intelligibility after surgery. Device soft failure was rare in our series, calling special attention to Mandarin speaking CI users requiring revision of their implants due to undesirable symptoms or decreasing performance of uncertain cause.