Complications of Cochlear Implant Surgery in Adults and Children

TLDR

Surgery for cochlear prosthesis insertion exposes patients to several potential risks. We review the surgical complication experience with cochlear implants in the United States. Major complications arise from surgical technique, such as flap necrosis, improper electrode placement, and rare facial nerve problems, while minor complications include incision dehiscence, infection, facial nerve stimulation, dizziness, and pedestal issues with the Ineraid device. No deaths were reported, and both major and minor complications were rare; complications were less frequent in children—especially those over 7 years—and were further reduced under tightly controlled protocols, with no increase in otitis media or sequelae in children receiving the Nucleus Mini‑22 device.

Abstract

Surgery for cochlear prosthesis insertion exposes the patient to several potential risks. We review the surgical complication experience with cochlear implants in the United States. There have been no deaths attributable to these devices, few serious major complications, and relatively few minor complications. Major complications usually have to do with surgical technique and include flap necrosis, improper electrode placement, and rare facial nerve problems. Minor complications include dehiscence of incisions, infection, facial nerve stimulation, dizziness, and pedestal problems with the Ineraid device. Complications were less frequent in children than adults and were more likely to occur in the younger children than those above the age of 7 years. Complications were still fewer in groups of patients operated on within tightly controlled protocols. There was no increased incidence of otitis media in children who received the Nucleus Mini-22 device, and no reported sequelae from such otitis when it occurred.