Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK

Abstract

Objectives

Since being approved in 2009, bilateral simultaneous cochlear implantation (CI) has been the standard treatment for children in the UK who meet the criteria for CI. The aim was to report surgical outcomes of bilateral CI in the UK.

Methods

Between January 2010 and December 2011, 14 UK CI centres collected data prospectively: demographics, aetiology, use of imaging, device type, surgery duration, use of intra-operative electrophysiology, length of stay, and post-operative complications.

Results

1397 CI procedures in 961 CI recipients were included; 436 bilateral simultaneous, 394 bilateral sequential, and 131 unilateral. The majority (85%) were congenitally deaf. The commonest causes of acquired deafness were meningitis and cytomegalovirus infection. The median age for congenitally deaf bilateral simultaneous CI was 2.2 years, mean surgical duration 4.5 hours. 6.3% surgeries were day case procedures. Eight cases (2.0%) of planned bilateral CI had unilateral surgery. The overall major complication rate was 1.6% (0.9% excluding device failures), including explantation due to infection (0.2%), cerebrospinal fluid leak (0.2%), and meningitis (0.1%). There were no permanent facial nerve palsies and no deaths. Sixty-two (6.5%) immediate minor complications included 12 (1.3%) children with significant vestibular impairment. The complication rate was similar following bilateral CI compared to sequential and unilateral CI, and is comparable to other published series.

Conclusion

This prospective multi-centre audit provides evidence that bilateral paediatric CI is a safe procedure in the UK, thus endorsing its role as a major therapeutic intervention in childhood deafness.

Keywords:

• Cochlear implant
• Pediatric
• Audit
• Complications

Acknowledgement

The following members of the UK National Paediatric Cochlear Implant Surgical Audit Group contributed to the data collection for this study:

Aleksy W¹, Axon PR², Banerjee A³, Bele D⁴, Bowcott S⁵, Bruce IA⁶, Cochrane LA⁷, Cooper S⁸, Daft M⁹, Donnelly N², Fitzgerald O'Connor A⁸, Freeman SR⁶, Gray RF², Green KMJ⁶, Hajioff DA⁵, Hanvey K¹⁰, Harris R¹¹, Hartley BEJ⁷, Hartley D⁹, Hatton N², Hawthorne MH³, Hellier W⁴, Humphries J¹², Irving R¹⁰, Jiang D⁸, Jephson CG⁷, Jonas NE⁷, Jones L³, Khan IMJ¹³, Lavy JA¹, Lloyd SK⁶, Maddocks J⁵, Maggs JK¹⁰, Marshall AH⁹, Martin JM¹³, Millward K⁶, Mitchell T⁴, Morrison G⁸, Patel S¹¹, Pringle M⁴, Raine CH¹³, Rajput KM⁷, Ramsden JD¹², Ramsden RT⁶, Reid AP¹⁰, Robinson PJ⁵, Saeed SR¹, Selvadurai D¹¹, Shaida A¹, Speers A¹⁴, Strachan DR¹³, Toner JG¹⁴, Tysome JR², Tzifa K¹⁰, Twomey T⁹, Wheeler A¹, Wilson K⁸, Wyatt ME⁷

1.	Royal National Throat Nose and Ear Cochlear Implant Programme, London
2.	Cambridge Emmeline Centre Paediatric Implant Programme
3.	North East Cochlear Implant Programme, Middlesbrough
4.	South of England Cochlear Implant Programme, Southampton
5.	West of England Paediatric Cochlear Implant Programme, Bristol
6.	Manchester Cochlear Implant Programme
7.	Great Ormond Street Cochlear Implant Programme, London
8.	St. Thomas’ Hospital Paediatric Auditory Implant Programme, London
9.	Nottingham Cochlear Implant Programme
10.	Birmingham Children's Cochlear Implant Programme
11.	St. George's Hospital Cochlear Implant Programme, London
12.	Oxford Cochlear Implant Programme
13.	Yorkshire Cochlear Implant Service, Bradford
14.	Belfast Regional Cochlear Implant Centre