Cochlear reimplantation

Objective: A small number of multichannel cochlear implant (CI) recipients require reimplantation. This study describes the causes of failure, surgica l technique, and hearing outcomes in a consecutive series of 16 patients un dergoing reimplantation of multichannel devices. We hypothesize that reimpl antation is safe and that hearing results are at least as good as those mea sured following primary implantation, Study Design: Retrospective analysis of consecutive clinical series, Methods: Chart analysis of 191 consecutive CI operations performed at the University of Miami Ear Institute between 19 90 and 1997 revealed 16 patients who received a second multichannel device. All but one had a minimum follow-up of 1 year after reimplantation, Ten of these patients had initial implantation performed by us, and six were init ially operated on elsewhere. Main outcomes of the initial procedure were co mpared with those of the reimplantation, including electrode insertion leng th, number of channels programmed, and audiometric results. In addition, ca use of failure and relevant surgical findings at the second procedure are d escribed. Results: There were no surgical complications after reimplantatio n surgery. Device failure was the most frequent cause for reimplantation. T ime between initial implantation and failure ranged from 0 to 46 months (me an, 22.4 mo; median, 23 mo). Common intraoperative findings include mastoid fibrosis, bone growth at the cochleostomy, and skin flap breakdown, Follow ing reimplantation, mean length of insertion, number of channels actively p rogrammed, and speech recognition scores were at least as good as findings before initial implant failure. Conclusion: CI reimplantation is safe and e ffective.