title: Analyzing complications of minimally invasive pediatric cochlear implantation: A review of 248 implantations.
abstract: OBJECTIVE
  This study aims to report the postoperative complications and management of cochlear implantation in pediatric patients at our institution. All procedures were carried out by a single surgeon utilizing minimally invasive techniques. The impact of past surgical history of tympanostomy tubes was also reviewed to access association with postoperative complications.
  
  
  METHODS
  All children receiving cochlear implants at our institution between April 2003 and October 2014 were reviewed. Complications were grouped into "major" and "minor" depending on degree of management and "immediate," "early," and "delayed" depending on time of presentation.
  
  
  RESULTS
  In our series, 248 cochlear implants were placed into 141 children. The mean age at time of surgery was 4.8 years. The overall complication rate per ear was 16.5%, 5.2% being major and 11.3% being minor complications. Complications arose in the first 30 days following surgery in 8.4% of patients, with acute otitis media being the most common. A history of tympanostomy tubes did not impact complication rate. Excluding device failures, major complication rate was 2.4%. Hematoma was not encountered, and delayed seroma occurred in one patient.
  
  
  CONCLUSIONS
  Minimally invasive cochlear implantation carries a low complication rate. The most common major complication was intrinsic device failure, and the most common minor complication was acute otitis media. Past medical history of chronic otitis media with tympanostomy tube placement prior to cochlear implantation did not have a statistically significant impact on postoperative complication rates. Given the rarity of hematomas and seromas, pressure dressings appear to be unnecessary with this approach.
authors.affiliation: University of Mississippi School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA; Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA. Electronic address: bgooge@umc.edu.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Googe
authors.affiliation: Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Carron
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000209:etiology; D019929:Cochlear Implantation / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies