title: Early complications following cochlear implantation in children and their management.
abstract: OBJECTIVE
  To report the early postoperative complications of cochlear implantation (CI) in the pediatric population and discuss the intervention measures.
  
  
  METHODS
  We retrospectively analyzed 260 consecutive pediatric cochlear implantations performed at the First Affiliated Hospital of Zhengzhou University between March 2010 and July 2013. All patients were younger than 12 years old at the time of implantation, with a mean age of 4.3 years, and 47 cases had inner ear malformations. Complications correlated to age at CI and inner ear malformations were analyzed using the χ(2) test.
  
  
  RESULTS
  Of the 260 patients, early postoperative complications were observed in 17 (6.54%) cases, of which 16 (6.15%) were minor and one (0.38%) was major, none required surgical device removal or reimplantation. Among the 16 minor complications, transient vertigo was the most common (nine cases, 3.46%), three (1.15%) of them with severe CSF gusher during the surgery; followed by transient facial nerve palsy (two cases, 0.77%, both were reversible); external auditory canal injury, subcutaneous hematoma each in two cases (0.77%), and minor dural injury in one case (0.38%). One major complication included an epidural hematoma in a 7-year-old boy who recovered completely without any neurologic deficits following immediate evacuation. Inner ear malformations were significantly associated with the surgical complications, especially vertigo and gusher (P<0.05).
  
  
  CONCLUSIONS
  Cochlear implantation in children is fairly a safe procedure with a relatively low complication rate. The most common early postoperative complications are minor, but serious and life threatening complications rarely may occur. Awareness of complications helps clinicians to adopt the specific preventive measures and immediate interventions so that the outcome will be successful.
authors.affiliation: Department of Otology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China.
authors.forename: Sujuan
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Otology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China. Electronic address: qzb@zzu.edu.cn.
authors.forename: Zhaobing
authors.initials: Z
authors.lastname: Qin
authors.affiliation: Department of Otology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Otology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Otology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China.
authors.forename: Sihan
authors.initials: S
authors.lastname: Qi
authors.affiliation: Department of Otology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000209:etiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants; D004424:Ear Canal / Q000293:injuries; D007758:Ear, Inner / Q000002:abnormalities; D005158:Facial Paralysis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006407:Hematoma, Epidural, Cranial / Q000209:etiology / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D014717:Vertigo / Q000209:etiology
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
keywords: Children, Cochlear implantation; Operative complication; Surgery