Surgical outcomes of paediatric cochlear implantation: the Hospital for Sick Children's experience.
OBJECTIVE
Cochlear implantation in children represents a special challenge for the otologist because of such factors as skull dimensions and postimplantation temporal bone growth. As implant programs accrue increasing numbers of children, surgical factors relating to outcomes can be analyzed.


METHODS
A retrospective study was performed of all children receiving a cochlear implant from January 1990 through May 1997 at The Hospital for Sick Children (HSC). The surgical procedure as well as the complications encountered were examined. Fifty two children, 28 females (54%) and 24 males (46%) were implanted.


RESULTS
Overall, the average age at time of implantation was 7.0 years (range, 1.9-17.3 yr). The presumed cause of deafness was acquired in five children (10%) and congenital in the remaining 47 patients (90%). A recognized syndrome was associated with the hearing loss in only three patients. There were two minor complications (3.8%) and two major complications (3.8%) with an overall complication rate of 7.6%. There were no episodes of device or electrode migration. Two surgical innovations are also discussed: 1) a new periosteal flap design which decreases device mobility, and 2) a new technique for electrode fixation (NED's knot).


CONCLUSIONS
The HSC experience represents the largest paediatric cochlear implant series in Canada. The findings indicate that the procedure is safe and is associated with infrequent morbidity.
de Jong
A L
AL
Department of Otolaryngology, Hospital for Sick Children, Toronto, Ontario.
Nedzelski
J
J
Papsin
B C
BC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000151:congenital / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D013524:Surgical Flaps