title: Surgical considerations in cochlear implantation in children and adults: a review of 342 cases in Vienna.
abstract: CONCLUSIONS
  Our data represent the experience of the largest cochlear implant program in Austria. In conclusion, cochlear implantation is a safe procedure, associated with a low rate of intra- and postoperative complications. Nevertheless, patients should be informed about possible problems and especially about the risk of a reoperation due to device failure.
  
  
  OBJECTIVE
  To evaluate the cause of deafness, the intraoperative findings and the complication rate for all cochlear implant operations performed consecutively between 1994 and 2003 at Vienna General Hospital.
  
  
  METHODS
  Including all surgeries for bilateral implantation and revision, a series of 342 operations performed on 164 adults (age range 14.5-81 years; mean age 50.79 years) and 128 children (age range 0.75-14 years; mean age 5.00 years) was retrospectively analyzed.
  
  
  RESULTS
  The etiology of deafness was predominantly congenital or progressive (66.89%). The routine mastoidectomy approach was chosen in 300 patients (87.72%) and the suprameatal approach in 42 (12.28%). Intraoperatively, 4 children (2.53%) had a cerebrospinal fluid fistula and 35 patients (10.23%) showed cochlear ossification. Three adults (1.63%) and two children (1.27%) had facial nerves with an aberrant course. The overall complication rate was 12.2%, the rate of major complications was 4.97% and the rate of minor complications was 4.09%. There were no cases of either postoperative meningitis or facial nerve palsy. Both flap necrosis and electrode dislocation occurred in one adult patient (0.54%), but in none of the children. Formation of cholesteatoma was found in one adult (0.54%) and one child (0.63%). The rate of device failure was 7.07% for adults and 13.92% for children.
authors.affiliation: Department of Otorhinolaryngology, Medical School, University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Arnoldner
authors.forename: Wolf Dieter
authors.initials: WD
authors.lastname: Baumgartner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gstoettner
authors.forename: Jafar
authors.initials: J
authors.lastname: Hamzavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D002558:Cerebrospinal Fluid Otorrhea / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D015834:Cochlear Diseases / Q000473:pathology; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D003054:Cochlear Implants; D003638:Deafness / Q000209:etiology / Q000601:surgery*; D007758:Ear, Inner / Q000002:abnormalities; D004432:Ear, Middle / Q000002:abnormalities; D005260:Female; D005402:Fistula / Q000473:pathology; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000473:pathology; D017063:Outcome Assessment, Health Care; D011475:Prosthesis Failure; D012189:Retrospective Studies