Postoperative complications in patients with cochlear implants and impacts of nursing intervention

Abstract

Conclusion: This study shows that cochlear implantation is relatively safe surgery with few major complications and within acceptable limits. However, close follow-up observation and effective medical and nursing intervention could alleviate further complications and thus become key elements for promoting recovery of patients undergoing such surgery. Objectives: Cochlear implantation has become an effective method for curing patients disabled by profound hearing loss in China. However, full exploration of the associated complications remains to be completed. The objective of this study was thus to analyse the postoperative complications in patients with cochlear implants (CIs) in order to design improved measures for clinical and nursing interventions. Methods: A retrospective study of 262 patients receiving CIs at the Department of Otorhinolaryngology/Head and Neck Surgery, Chinese People's Liberation Army General Hospital, Beijing, China from March 1997 to December 2006 was conducted. Results: Among 262 patients, 4 cases (1.5%) had 1 or more major complications requiring substantial medical or nursing interventions, including 1 case of cerebrospinal fluid (CSF) otorrhoea accompanied by meningitis, 2 cases of facial nerve paresis and 1 case of perforation of tympanic membrane. Forty cases (15.3%) had some form of minor complication that settled spontaneously or easily with conventional treatments and nursing, of which dizziness and vomiting was the most frequent (4.2%), followed by CSF gusher without otorrhoea and/or induced meningitis (2.7%), tinnitus (1.9%) and facial nerve partially exposed without paralysis (1.5%). Eleven cases (4.2%) had some symptoms associated with installation of the cochlear device. Except for one patient who had no response after implantation because his auditory nerves were underdeveloped, all the patients who received appropriate treatment and nursing intervention had a favourable prognosis.

Keywords::

• Cochlear implantation
• post-surgery complications
• nursing strategies

Acknowledgments

This work was supported by grants from the National Natural Science Foundation of China Key Project (grant no. 30830104), the National Natural Science Foundation of China (grant nos 30771203 and 30672310), the Chinese Foundation of National Excellent Doctoral Thesis (grant no. 200463), Beijing Nature Science Technology Major Project (grant nos D0906005040291 and 7070002), the Chinese National 973 Project (grant no. 2007CB507400), the Chinese National Eleventh Five-years Scientific Program (grant nos 2006BAI02B06 and 2007BAI18B12), Natural Science Foundation of Guangdong Province, China Key Project (Grant No. 8251008901000007) and the Sun Yat-Sen University Start-up Fund (grant no. 3171310). We wish to thank the patients and their families for their cooperation during this work. The authors would like to thank all the medical staff from Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital for their great help during this study. We also thank Cindy Benedict-Alderfer for editorial assistance with this manuscript. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.