Revision Cochlear Implantation With Device Manufacturer Conversion: Surgical Outcomes and Speech Perception Performance

Objective: Describe the clinical profile of revision cochlear implantation (RCI) cases involving device manufacturer conversion (RCI^mc+), compare them to cases without manufacturer conversion (RCI^mc−), and classify the reasons for manufacturer conversion (MC). Study Design: Retrospective case review. Setting: Tertiary academic center. Methods: Data on demographics, RCI indications, medical background, surgical details, and the reasons for MC were collected for all RCIs from 1989 to 2020. Post-RCI speech perception performance was categorized as unchanged, improved, or declined, according to clinically based criteria. Results: Of 185 RCIs, 39 (21%) involved MC, mostly in pediatric patients (67%). The leading RCI^mc+ indications were device-related (59%) and medical (31%) failures. Initial implant manufacturers were Advanced Bionics (49%), Cochlear (25.5%), or Medel (25.5%). Most MC reasons were patient-driven (64%) versus CI team recommendations (36%). The RCI^mc+ group demonstrated a 3-fold higher rate of medical indications than RCI^mc− (31% vs 11.5%, P =.007). The time interval from symptom onset to RCI was longer in RCI^mc+ (43 vs 20.3 months, P =.001), and the rate of multiple revisions in the same ear was higher (25.6% vs 8.2%, P =.009). Complete reinsertion rates were high in both RCI^mc+ and RCI^mc− (94.8% vs 94.5%, P = 1) without any complications. Speech perception improved or remained unchanged in most (84%) cases, with no significant difference between the groups (P =.183). Conclusion: This retrospective study showed that RCI involving MC is safe and beneficial. Although RCI^mc+ patients exhibited distinct clinical characteristics, MC did not impact surgical or speech perception outcomes. This provides evidence-based data to support informed decision-making by CI teams and patients.