title: Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations.
abstract: OBJECTIVE
  The purpose of this study is to assess complications occurring after cochlear implantation (CI) in children and to discuss revision surgeries and medical interventions occurring during follow-up.
  
  
  METHODS
  Retrospective study of 475 consecutive pediatric cochlear implantations at a tertiary referral center.
  
  
  METHODS
  The patients (n = 475) who received cochlear implants in our institution between March 2000 and March 2012 were followed up (range, 5 months-12 years). All complications were systematically reviewed, and their causes were analyzed for prevention and therapy.
  
  
  RESULTS
  All children received unilateral CI. Mean age at implantation was 3 years 7 months (ranged from 10 months to 18 years). Forty-three patients (9%) experienced complications. Twenty-one patients (4.4%) had major complications, consisting of device failure (10 patients), flap necrosis (4 patients), meningitis (2 patients), electrode shifting (2 patients), hematoma (2 patients) and magnet migration (1 patient). Twenty-two (4.6%) had minor complications, consisting of acute otitis media (5 patients), skin lesion due to pressure reaction in contralateral ear during surgery (4 patients), flap swelling (3 patients), minor wound infection (3 patients), transient facial paralysis (2 patients), transient vertigo (2 patients), hematoma (1 patient), facial stimulation (1 patient), subcutaneous emphysema (1 patient). Complications led to reimplantation in 13 (30.2%) and other revision surgery in 7 (16.2%) of the 43 patients. One patient with meningitis cured with medical treatment and 22 patients with minor complications cured with either medical treatment or spontaneously.
  
  
  CONCLUSIONS
  Cochlear implantation is a safe technique in experienced hands with a relatively low complication rate. Long term follow up is mandatory to minimize and control surgical complication.
authors.affiliation: Çukurova University Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery, Adana 01330, Turkey. ozgur_tarkan@yahoo.com
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Tarkan
authors.forename: Ülkü
authors.initials: Ü
authors.lastname: Tuncer
authors.forename: Süleyman
authors.initials: S
authors.lastname: Özdemir
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Sürmelioğlu
authors.forename: Fikret
authors.initials: F
authors.lastname: Çetik
authors.forename: Mete
authors.initials: M
authors.lastname: Kıroğlu
authors.forename: Erhan
authors.initials: E
authors.lastname: Kayıkçıoğlu
authors.forename: Karahan
authors.initials: K
authors.lastname: Kara
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome