The impact of temporal bone CT-scans in the treatment of postoperative complications after Cochlea-implantation

Introduction:

The complication rate of cochlear implant (CI) patients is low. For the clarification of CI-associated complaints, e.g. pain or limited CI performance a temporalbone CT scan (tCT) is a diagnostic option. In childhood this is often associated with anesthesia and in general with radiation. The aim of this study is to examine the impact of the tCT in case of CI-associated complaints.

Methods:

Retrospective analysis was performed in CI patients who received tCT between 2007 and 2016 because of new complaints.

Results:

In 78 CI patients 89 tCT were performed. The age structure was: 9% between 0 – 4 years, 34.8% between 5 – 18 years and 56.2% over 18 years. The reasons for a tCT were: otalgia/pain in the region of the implant (33%), poor CI performance (22%), trauma (13%) and subjective implant failure (10%). In 55% of the cases an inconspicuous tCT was found of which half were 0 – 18 years. Frequently, less fluid was seen in the mastoid, with no evidence of mastoiditis (23%). A dislocation or kink of the electrode was seen in 11% of the cases. Acute mastoiditis was diagnosed in 2%. A fracture could not be detected. In summary of all clinical findings 28% (0 – 4 years: 4%, 5 – 18 years: 13%, 18+: 10%) received surgery. In about half of these cases, re-implantation was necessary (15%, 60% of these cases with inconspicuous tCT). The association between a subject implant failure and CI-re-implantation was significant after chi-square test (p < 0.05).

Conclusion:

In cases of subjective implant failure the indication of tCT should be critically assessed in the absence of adding some benefit. Nevertheless, the indication for a tCT in cases of CI-associated complaints is an individual decision.

Publication History

Publication Date:
18 April 2018 (online)