Revision cochlear implant surgery in adults and children is a safe and effective technique: a retrospective single faculty study in Okayama University Hospital, Japan

Background: Cochlear implant (CI) surgery is a safe surgical technique, although some patients require revision CI surgery.Aims/Objectives: This study investigated the cause and underlying reason of revision CI surgery as well as hearing outcomes in a single institution.Patients and Methods: This retrospective study evaluated patients who underwent CI surgery between April 2006 to March 2022 (n=351). Sex, aetiology of hearing loss (HL), age and period from initial CI surgery to reimplantation, cause of revision, and related factors were examined.Results: Twelve patients (8 males, 4 females) received CI reimplantation. The revision surgery rate was 2.59% (3.15% children, 1.69% adults); the period from initial surgery to reoperation was 8.60 +/- 6.56years for 9 children with congenital HL and 15.27 +/- 5.72years for 3 adults with progressive HL. Device failure was the most common cause (n=8), followed by infections (n=2), advanced facial irritation symptoms (n=1), and electrode slip-out (n=1). Mean preoperative and postoperative CI thresholds were 44.0 +/- 9.46 dBnHL and 39.19 +/- 8.89 dBnHL (p<.068), respectively.Conclusion and Significance: Caregiver education, surgical technique advances, flap design, and extensive antibiotic use may decrease the revision surgery rate. The lack of post-revision deterioration of the hearing threshold contributed to well-being in patients with CI.