title: Revision cochlear implant surgery in adult patients with suspected device malfunction.
abstract: OBJECTIVE
  To report the outcomes of patients that have undergone revision cochlear implant surgery for suspected device malfunction.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Adult cochlear implant patients with devices that fail to lock or maintain a lock but are associated with troubling signs and symptoms.
  
  
  METHODS
  Revision cochlear implant surgery.
  
  
  METHODS
  Demographics, presenting signs and symptoms, surgical findings, complications, audiologic performance and device analysis.
  
  
  RESULTS
  To date, 33 revision cochlear implant operations have been performed in 30 patients. Eight (24%) presented with a failure of the speech processor to lock with the internal device (i.e., hard failure). Twenty-five (76%) presented with either aversive auditory (n = 23 [92%]) or nonauditory (n = 21 [84%]) symptoms or performance-related issues (n = 16 [64%]) while maintaining a lock (i.e., suspected soft failure). Revision surgery resulted in resolution of the patient's presenting signs and symptoms in nearly 90% of cases and significant improvements in auditory performance. Perioperative complications were uncommon. Preoperative testing and device analysis frequently did not reveal the reason for presumed device malfunction.
  
  
  CONCLUSIONS
  Revision cochlear implantation should be considered in patients significantly affected by intolerable auditory and/or nonauditory symptoms or when performance issues have been documented.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 27599-7070, USA. buchman@med.unc.edu
authors.forename: Craig A
authors.initials: CA
authors.lastname: Buchman
authors.forename: Carol A
authors.initials: CA
authors.lastname: Higgins
authors.forename: Robert
authors.initials: R
authors.lastname: Cullen
authors.forename: Harold C
authors.initials: HC
authors.lastname: Pillsbury
mesh_terms: D000704:Analysis of Variance; D001299:Audiometry; D019929:Cochlear Implantation / Q000592:standards*; D003638:Deafness / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome