RESUMO
Abstract Introduction: The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. Objective: To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. Methods: A retrospective study of patients under 18 years submitted to cochlear implant surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after cochlear implant surgery and any need for surgical revision and the reason for it. Results: Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. Conclusion: The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases.
Resumo Introdução: A cirurgia para a implantação do dispositivo interno do implante coclear não é inteiramente livre de riscos e pode apresentar problemas que exigem cirurgias revisionais. Objetivo: Verificar a incidência das indicações de cirurgias revisionais para a implantação do dispositivo interno do implante coclear, sua efetividade e correlacionar às variáveis relacionadas às categorias de linguagem e audição. Método: Estudo retrospectivo de pacientes menores de 18 anos submetidos à cirurgia de implante coclear de 2004 a 2015 em um hospital público no Brasil. Os dados coletados foram: idade no momento da implantação, sexo, etiologia da surdez, características audiológicas e da linguagem oral de cada paciente no pré e pós-operatório, necessidade de revisão cirúrgica e razão para ela. Resultados: Foram feitas 265 cirurgias em 236 pacientes. Oito pacientes foram submetidos ao implante coclear bilateral e 10 necessitaram de cirurgia de revisão. Foram necessárias 32 cirurgias para essas 10 crianças (um implante coclear bilateral), das quais 21 foram cirurgias de revisão. Em duas crianças, a remoção do implante coclear foi necessária, sem realização de reimplante; uma delas apresentava malformação coclear, por partição incompleta tipo I; e a outra, devido a trauma. Quanto à causa da necessidade da cirurgia revisional, das oito crianças que permaneceram com implante coclear, quatro apresentaram calcificação coclear após meningite, seguida de trauma (1), malformação do nervo facial (1), falha do dispositivo interno da IC (1) e torção do feixe de eletrodos (1). Conclusão: A incidência de cirurgias revisionais foi de 4,23%. O pós-operatório das cirurgias revisionais permite uma melhoria no desempenho de audição e na linguagem dos pacientes, indicando que essas cirurgias são válidas na maioria dos casos.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Reoperação , Implante Coclear/efeitos adversos , Surdez/cirurgia , Percepção da Fala , Falha de Prótese , Estudos Retrospectivos , Remoção de Dispositivo , Testes AuditivosRESUMO
INTRODUCTION: The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. OBJECTIVE: To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. METHODS: A retrospective study of patients under 18 years submitted to cochlear implant surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after cochlear implant surgery and any need for surgical revision and the reason for it. RESULTS: Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. CONCLUSION: The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases.