How we do it: Local anaesthetic cochlear implantation

Abstract

Objectives

To review a patient series of 16 cochlear implantations performed under local anaesthetic (LA), including a description of the centre's technique for this procedure. We also describe the application of a method for calculation of the potential morbidity/mortality avoided by using this technique.

Methods

Chart review of 16 patients’ pre-operative medical and anaesthetic notes and calculation of predicted individual P-POSSUM Scores for operative morbidity/mortality.

Results

All 16 patients were implanted successfully with no significant complications. Age range was 26–92 years, with an average of 68 years. The patients’ average predicted mortality score associated with a general anaesthetic (GA) was 8.6% and morbidity score was 58%.

Conclusions

Our experience shows LA cochlear implantation to be a safe and effective procedure. It has the benefit of avoiding the operative mortality risk predicted by P-POSSUM Scores. Cochlear implantation is known to significantly improve quality of life for users. Our findings suggest a potential group of cochlear implant recipients considered ‘unfit’ for GA may be being denied access to this intervention or being exposed to additional risk.

Keywords:

• Local anaesthetic
• Cochlear implantation
• P-POSSUM
• Morbidity
• Mortality

Acknowledgements

We would like to acknowledge contribution of all the staff at the Cochlear Implant centre in Belfast and also our anaesthetic colleagues; Dr I Gillespie, Dr J McLaughlin, Dr B McGrattan, and Dr C Wilson.