Re-Implantation: Curse or blessing?

Introduction:

Any cochlear implant surgery bears the risk of later re-implantation due to technical or medical failure. In patients with an older implant a re-implantation for technical upgrade may be discussed to improve performance.

Aim:

to analyze speech understanding before and after re-implantation.

Methods:

We evaluated re-implantations between 1998 and 2017 in our CI-database. Best performance in audiometric testing (Freiburg numbers and monosyllables at 65/70 dB SPL) before and following re-implantation (duration of CI use at least or up to one year) was compared.

Results:

Re-implantations (n = 102) were caused by technical failure in n = 76 cases, and for medical reasons in n = 26 cases. Complete audiometric data were available in n = 46 cases. The evaluation shows a mean increase of 10% for both tests, being statistically significant for tests at 70 dB SPL. We noted a decrease in the Freiburg monosyllable test in n = 12 (26%) cases.

Conclusion:

We found a comparable or improved performance for the majority of patients. Nevertheless, 26% of patients demonstrated a poorer performance, even if the re-implantation resulted in a technical upgrade. Available data on performance following technical upgrades due to newer speech processors show a mean improvement of 15%. Therefore, the indication for re-implantation must be critically reflected and patients must be informed about a possible decrease in performance.

Publication History

Publication Date:
23 April 2019 (online)