gms | German Medical Science

Surgical aspects of 491 cochlear implantations in children (n=218) and adults (n=273) between 1998 and 2008 were evaluated.

There were no inflammatory alterations or damages to the skin flap. Twice the subcutis had to be thinned out over the magnet.

In 14 cases we found CSF gusher which could always be controlled just by otosurgic methods. In 7 of these cases a high pressure labyrinth could be diagnosed preoperatively by MRI and CT-scans.

One patient suffered from otogenic meningitis three years after cochlear implantation. By immediate surgery and antibiotic therapy meningitis healed up completely and the implant could be used again.

One patient developed a cholesteatoma of the attic five years after implantation because of chronic ventilation problems of the Eustachian tube. The cholesteatoma could be removed by leaving the implant in situ.

5% of the patients suffered from prolonged vertigo after surgery and had to undergo retraining therapy.

27 implants became dysfunctional due to different causes and could be changed without any difficulties.

Cochlea implant surgery is a safe microsurgic intervention of the middle and inner ear with very few complications. Thorough preoperative diagnosis can indicate possible intraoperative problems and complications. Patients have to be informed about possible risks in detail. They should be prepared for a change of the implant due to technical breakdown. Patients should have a contact person integrated in a supportive network for regular controls and to discuss possible problems.