Clinical Analysis of Techniques and Complications in 414 Consecutive Cochlear Implantations

Abstract

Aim: To report the frequency of surgical complications following 414 consecutive cochlear implant surgeries (402 children and 12 adults), compare standard and minimal access incisions, and evaluate the feasibility of using the minimal access approach for all cochlear implant candidates.

Methods: A retrospective analysis of patients who underwent cochlear implantation between February 2012 and February 2019 by a single surgeon at a single center.

Patients: The study included 414 consecutively implanted patients (323 standard incision and 91 minimal access incision). Demographic characteristics, surgical approaches, incision sizes, and operative details were analyzed.

Results: Among 414 patients, there were 30 surgery-related complications (12 major and 18 minor) and 11 device-related complications. Major complications included wound infection, device extrusion, electrode displacement, temporary cerebrospinal fluid (CSF) leak, and magnet displacement. Minor complications included transient facial paresis, vertigo, seroma, hematoma, and tinnitus. The overall complication rate (9.6%) was low compared with published literature.

Clinical Significance: Cochlear implantation is a low-risk procedure when performed by an experienced surgeon following standard protocols. The minimal access incision offers reduced morbidity, improved cosmetic outcomes, and adequate surgical exposure without compromising essential operative steps.