title: Medical and surgical complications in pediatric cochlear implantation.
abstract: OBJECTIVE
  To report complications of cochlear implantation (CI) in children and to analyze risk factors.
  
  
  METHODS
  Retrospective study from January 1, 1990, through April 30, 2008, with a mean follow-up of 5.5 years (range, 1 month to 17 years).
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  Four hundred thirty-four patients younger than 16 years. Mean age at CI was 4.7 (range, 0.6-16.0) years. Forty-one children (9.4%) underwent CI when younger than 24 months. Forty-three (9.9%) had inner ear malformations.
  
  
  METHODS
  Complications after CI, classified into early (0-8 days) or delayed (>8 days) and major or minor. Spontaneous failures of internal devices were excluded. Correlation to age at CI, local trauma, and inner ear malformations were analyzed using the chi(2) test.
  
  
  RESULTS
  Forty-three patients (9.9%) experienced complications. Delayed complications occurred in 28 patients (65.1%), with a mean delay of 2.2 (range, 0.1-8.4) years. Twenty-four patients (5.5%) had major complications, consisting of severe cutaneous infections (15 patients), magnet displacement (3), meningitis (2), cholesteatoma (2), cerebrospinal fluid leak (1), and electrode misplacement (1). Nineteen (4.4%) had minor complications, consisting of vertigo (9 patients), soft-tissue infection (5), persistent otitis media (4), and facial palsy (1). Complications led to reimplantation in 13 of the 43 patients (30.2%). Trauma to the mastoid area (14 patients) and inner ear malformations (51) were highly correlated with major delayed complications (P < .001) and early minor complications (P < .001), respectively. Young age at CI was not correlated with any type of complication.
  
  
  CONCLUSIONS
  Complications of CI in children are common, with trauma as a major factor. Inner ear malformations should prompt specific preventive management. Cochlear implantation in young children did not appear to be a risk factor in this study.
authors.affiliation: Service d'Oto-rhino-laryngologie Pédiatrique et de Chirurgie Cervico-faciale, Hôpital d'Enfants Armand-Trousseau, 26 Avenue du Dr Arnold Netter, 75012 Paris, France. natalie.loundon@trs.aphp.fr
authors.forename: Natalie
authors.initials: N
authors.lastname: Loundon
authors.forename: Marion
authors.initials: M
authors.lastname: Blanchard
authors.forename: Gilles
authors.initials: G
authors.lastname: Roger
authors.forename: Françoise
authors.initials: F
authors.lastname: Denoyelle
authors.forename: Erea Noël
authors.initials: EN
authors.lastname: Garabedian
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors