Revision cochlear implant surgery for clinical reasons

Objective. To report the authors' experience in a series of patients treated with cochlear implant (CI) revision surgery due to medical problems. Methods. Revision CI surgeries performed in a tertiary referral centre for medical reasons not related to skin conditions were reviewed; patients were included if device removal was required.Results. 17 cochlear implant patients were reviewed. The main reasons requiring revi-sion surgery with device removal were: retraction pocket/iatrogenic cholesteatoma (6/17), chronic otitis (3/17), extrusion in previous canal wall down procedures (2/17) or in previ-ous subtotal petrosectomy (2/17), misplacement/partial array insertion (2/17) and residual petrous bone cholesteatoma (2/17). In all cases surgery was performed through a subtotal petrosectomy. Cochlear fibrosis/ossification of the basal turn was found in 5 cases and un-covered mastoid portion of the facial nerve in 3 patients. The only complication was an abdominal seroma. A positive difference was observed between the number of active elec-trodes and comfort levels before and after revision surgery.Conclusions. In CI revision surgeries performed for medical reasons, subtotal petrosectomy offers invaluable advantages and should be considered as first choice during surgical planning.

Automated summary

This study reviewed a series of patients who underwent revision cochlear implant surgery due to medical reasons. The main reasons included retraction pocket/iatrogenic cholesteatoma, chronic otitis, and previous extrusion procedures. Cochlear fibrosis/ossification and uncovered facial nerve were found during surgery. After revision surgery, there was a positive difference in the number of active electrodes and comfort levels.