title: Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK.
abstract: OBJECTIVE
  Since being approved in 2009, bilateral simultaneous cochlear implantation (CI) has been the standard treatment for children in the UK who meet the criteria for CI. The aim was to report surgical outcomes of bilateral CI in the UK.
  
  
  METHODS
  Between January 2010 and December 2011, 14 UK CI centres collected data prospectively: demographics, aetiology, use of imaging, device type, surgery duration, use of intra-operative electrophysiology, length of stay, and post-operative complications.
  
  
  RESULTS
  1397 CI procedures in 961 CI recipients were included; 436 bilateral simultaneous, 394 bilateral sequential, and 131 unilateral. The majority (85%) were congenitally deaf. The commonest causes of acquired deafness were meningitis and cytomegalovirus infection. The median age for congenitally deaf bilateral simultaneous CI was 2.2 years, mean surgical duration 4.5 hours. 6.3% surgeries were day case procedures. Eight cases (2.0%) of planned bilateral CI had unilateral surgery. The overall major complication rate was 1.6% (0.9% excluding device failures), including explantation due to infection (0.2%), cerebrospinal fluid leak (0.2%), and meningitis (0.1%). There were no permanent facial nerve palsies and no deaths. Sixty-two (6.5%) immediate minor complications included 12 (1.3%) children with significant vestibular impairment. The complication rate was similar following bilateral CI compared to sequential and unilateral CI, and is comparable to other published series.
  
  
  CONCLUSIONS
  This prospective multi-centre audit provides evidence that bilateral paediatric CI is a safe procedure in the UK, thus endorsing its role as a major therapeutic intervention in childhood deafness.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Broomfield
authors.forename: John
authors.initials: J
authors.lastname: Murphy
authors.forename: Dominik C
authors.initials: DC
authors.lastname: Wild
authors.forename: Stevan R
authors.initials: SR
authors.lastname: Emmett
authors.forename: Gerard M
authors.initials: GM
authors.lastname: O'Donoghue
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D003054:Cochlear Implants; D004868:Equipment Failure; D005260:Female; D006312:Hearing Loss, Bilateral / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D061646:Operative Time; D011446:Prospective Studies; D013017:Sound Localization; D013067:Speech Perception; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Audit; Cochlear implant; Complications; Pediatric