title: Cochlear reimplantation in children: soft signs, symptoms and results.
abstract: OBJECTIVE
  Cochlear implant device failures and reimplantation have mainly been reported on in adults. The purpose of this study was to isolate precursors of device failures and assess the effects of reimplantation in children.
  
  
  METHODS
  From 1997 to 2003, 27 children underwent cochlear reimplantation at our institution. The pre-failure complaints were categorized and correlated with actual failure modes and postimplantation results. Speech-recognition tests were used to evaluate pre- and post-reimplantation performance.
  
  
  RESULTS
  Pre-failure length of usage ranged from 0 to 12 years. Symptoms including pain, intermittence, reduced performance, noise and the need for frequent device adjustments were associated with device failures, although not with a particular mode of failure. Post reimplantation performance was equal to but not immediately better than pre-failure results in children who received upgraded devices.
  
  
  CONCLUSIONS
  Specific complaints, frequent need for device adjustments and reduced speech recognition can be precursors to device failures, underscoring the need for routine follow-up evaluations. Reimplantation with newer technology does not guarantee improved speech understanding and often requires an adjustment period to reach pre-reimplantation levels.
authors.affiliation: New York University School of Medicine, New York, NY, USA. susan.waltzman@med.nyu.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Waltzman
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Roland
authors.forename: Michael
authors.initials: M
authors.lastname: Waltzman
authors.forename: William
authors.initials: W
authors.lastname: Shapiro
authors.forename: Anil
authors.initials: A
authors.lastname: Lalwani
authors.forename: Noel
authors.initials: N
authors.lastname: Cohen