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.
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 |