부산대학교 도서관

Introduction: Cochlear implantation is a surgical treatment for patients with severe-to-profound sensorineural hearing loss. In the course of time, eventually explantation and reimplantation will be an issue in our patients for various reasons. The implant may fail to function (hard failure), or needs to be removed because for example medical problems (e.g. wound infections). Frequently, patients will be reimplanted with a technically superior device. Materials and methods: In this study, we reviewed the rate of explantation and reimplantation in two cohorts of consecutively implanted children and adults. One cohort (Radboudumc, Nijmegen) consisted of 1800 patients, implanted between 1987 and 2017. In this cohort, there were 56 reimplantations (3.1%). In the second cohort (St. Augustinus hospital Wilrijk), consisting of 771patients implanted between 1987 and 2017, there were 21 re-implantations (2.7%). The evaluated data were: demographic information, type of implant (old and new), reason for explantation, type of implant failure (soft versus hard failure), speech coding strategy before and after explantation and audiometric results (speech recognition measured with NVA phoneme scores). Results: Reimplantation was feasible in all subjects. Speech recognition scores after reimplantation were comparable to the highest speech recognition scores assessed with the previous cochlear implant. If implant type and speech strategy did not change (N=27), the mean phoneme scores improved with 9.6% (SD=19.8%). In case of a reimplantation with a technically improved type of cochlear implant (N=23), the mean phoneme improvement was 8.6% (SD=16.9%). In case the reimplantation implied both a technically improved cochlear implant type and speech coding strategy (N=9), the mean phoneme improvement was 15.2% (SD=20.2%) Because of the large variations, these differences were not significant (p=0.086). Conclusion: Cochlear reimplantation is surgically feasible on the short as well as on the long term after explantation of a previous device. Devices upgrade, technically and/or in speech coding strategy, showed a positive trend towards improved speech recognition scores. [ABSTRACT FROM AUTHOR]