The etiological factors and outcomes of cochlear reimplantation surgery

Purpose: In this study cochlear reimplantation was evaluated with the aim of enlightening diagnosis, etiological factors, surgical features and postoperative auditory performances of cochlear reimplantation surgery. Materials and Methods: Thirty-nine patients who underwent reimplantation surgery at Otorhinolaryngology Department of Cukurova University Medical Faculty were classified according to the causes of reimplantation surgery. The factors that are effective on causes of reimplantation surgery, time of duration between initial cochlear implantation and reimplantation surgery, postoperative auditory performances were rewieved retrospectively. Results: Thirty-four cases (%3,1) of 1051 patients who were performed initial cochlear implantation surgery in our clinic were also underwent reimplantation surgery in our clinic. In addition to this; 5 reimplantation surgery cases who had their initial cochlear implantation surgery at another centre were enrolled in our study. Reimplantation surgery was performed by experienced surgeons in our clinic. The mean time of between initial cochlear implantation and reimplantation surgery was 4,1 (0-13) years. Reimplantation etiologies of 39 patients who underwent reimplantation surgery in our clinic were examined; there were 23 (%58,9) '' hard failure'' , 8 (%20,5) ''soft failure'', 4 (%10,3) flap infection, 1 (%2,6) cholesteatoma, 3 (%7,7) misplacement-displacement of electrode. All of the electrodes were succesfully advanced despite the ossification around the electrodes and cochleostomy in 10 reimplantation surgeries of 39 patients. The patients had open-set two syllable word test scores in the initial cochlear implant; mean phoneme was found 37,53 (0-50), mean word was found to be 6,86 (0-10). The mean Cap scores of patients were determined as 5,14 (0-7) in initial cochlear implants. When open-set two syllable word test scores of patients were evaluated after reimplantation follow-up; the mean phoneme was found 43,76 (0-50), and the mean word was found 8,24 (0-10). The mean Cap scores after reimplantation of these patients were detected as 6.3 (1-7). Conclusion: The most common cause of reimplantation surgery is associated device failure, which should be detected early in children, especially in the prelingual period. Patients with poor auditory performance after reimplantation surgery are often accompanied by neuropsychiatric disturbances which adversely affect the outcome after reimplantation surgery. There was no decrease in the auditory performance of patients after reimplantation surgery. Keywords: Reimplantation surgery , cochlear implant device failure, auditory speech performance