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

Yifat Yaar-Soffer*, Yisgav Shapira, Doron Sagiv, Ziva Yakir, Amit Wolfovitz, Yael Henkin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Describe the clinical profile of revision cochlear implantation (RCI) cases involving device manufacturer conversion (RCImc+), compare them to cases without manufacturer conversion (RCImc−), 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 RCImc+ 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 RCImc+ group demonstrated a 3-fold higher rate of medical indications than RCImc− (31% vs 11.5%, P =.007). The time interval from symptom onset to RCI was longer in RCImc+ (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 RCImc+ and RCImc− (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 RCImc+ 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.

Original languageEnglish
JournalOtolaryngology - Head and Neck Surgery
DOIs
StateAccepted/In press - 2024

Keywords

  • cochlear implant
  • device failure
  • hard failure
  • indications
  • manufacturer
  • revision
  • soft failure
  • speech perception performance
  • surgical outcomes

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