Cochlear implant complications in 403 patients: Comparative study of adults and children and review of the literature

Objectives: The purpose of this study was to assess the postoperative complications related to cochlearimplants and to discuss the differences observed between adult and paediatric populations. Cochlearimplant complications were defined as any pathological events observed during the postoperative period,whether or not they were directly related to the surgical technique. We therefore recorded all complica-tions, in the broad sense of the term, ranging from acute otitis media to cochlear explantation.Study design: Retrospective analysis of cochlear implant patients.Material and methods: All surgical procedures (unilateral or bilateral cochlear implantation, revisionsurgery) performed in our institution between March 1993 and January 2013 were reviewed. This popula-tion comprised 168 adults (median age at the time of implantation: 51.9 years), and 235 children (medianage at the time of implantation: 4.5 years). All postoperative complications were classified as either major(requiring surgical revision or hospital management) or minor (requiring conservative management).Results: The global complication rate was 19.9% (80/403 cases), comprising 5% of major complications(20 cases) and 14.9% of minor complications (60 cases). This complication rate was significantly higherin the adult population (P = 0.004).Conclusion: Cochlear implantation is a safe hearing rehabilitation surgical technique associated with alow complication rate. However, surgeons must be familiar with these complications in order to ensureoptimal prevention. Minor complications were mainly infectious in children (acute otitis media) andcochleovestibular in adults (tinnitus and vertigo). Major complications were mostly reimplantation fol-lowing revision surgery or device failure. Only the minor complication rate was significantly higher inthe adult population.