title: Safety of cochlear implantation before 12 months of age: Medical University of South Carolina and Pediatric American College of Surgeons-National Surgical Quality improvement program outcomes.
abstract: OBJECTIVE
  The primary objective of this study was to determine the safety profile of cochlear implantation (CI) in infants <12 months old.
  
  
  METHODS
  Retrospective review of institutional (Medical University of South Carolina [MUSC]) and national data (Pediatric American College of Surgeons-National Surgical Quality Improvement Program [ACS-NSQIP]).
  
  
  METHODS
  Cases were subdivided into two groups according to age at CI: <12 months and 12 to 18 months. The primary outcome measure of interest was occurrence of a postoperative medical or surgical complication. Operative time, anesthesia time, time in the postoperative anesthesia care unit, and length of stay were also assessed.
  
  
  RESULTS
  In infants <12 months of age, the incidence of a 30-day postoperative surgical complication using the ACS-NSQIP database was 3.6%; this did not differ from the rate observed in the 12- to 18-month-old group (3.2%, P = 1.0). In the MUSC series, the occurrence of a 30-day postoperative complication in children <12 months old was comparable (2.7%). At longer-term follow-up (mean = 3.7 years), the incidence of a postoperative surgical complication in infants <12 months old using MUSC data was 13.5%. When compared to older children at longer-term follow-up, no difference was noted (12.7%, P = 1.0). The incidence of a postoperative medical or anesthetic complication in children <12 months of age was extremely rare in both MUSC and ACS-NSQIP series (0% and 1.3%, respectively).
  
  
  CONCLUSIONS
  Institutional and national data demonstrate that CI in children <12 months of age is a safe procedure. Although infants <12 months old are at risk for postoperative complications, the rates of surgical and medical complications were no different compared to children 12 to 18 months of age.
  
  
  METHODS
  4 Laryngoscope, 126:707-712, 2016.
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Brendan P
authors: BP
authors: O'Connell
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Meredith A
authors: MA
authors: Holcomb
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Daniel
authors: D
authors: Morrison
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Ted A
authors: TA
authors: Meyer
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: David R
authors: DR
authors: White
mesh_terms: D000367:Age Factors; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D003054:Cochlear Implants; D015331:Cohort Studies; D016208:Databases, Factual; D003638:Deafness / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D061214:Patient Safety; D010372:Pediatrics; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D011475:Prosthesis Failure; D058996:Quality Improvement; D012189:Retrospective Studies; D018570:Risk Assessment; D012577:Schools, Medical; D012955:Societies, Medical; D013022:South Carolina; D016896:Treatment Outcome
keywords: Early cochlear implantation; infant cochlear implantation; medical complications; safety profile; surgical complications