Consideration for routine outpatient pediatric cochlear implantation: A retrospective chart review of immediate post-operative complications.
BACKGROUND
Cochlear implantation is well accepted as the treatment of choice for prelingual deafness in children [1]. However, the safety of routinely performing this procedure on an outpatient basis is debated. We aim to assess immediate postoperative complications that would affect a surgeon's decision to perform pediatric cochlear implantation on an outpatient basis.


METHODS
A retrospective chart review was conducted which included all children 17 years old or younger who underwent cochlear implantation from 2004 to 2014 in a private neurotology practice. The immediate postoperative complication rates and types of complications were then examined.


RESULTS
A total of 579 cochlear implants were placed in children ages 1-17 years old from 2004 to 2014. The most common complications were nausea/vomiting and dizziness/imbalance. The odds ratio of developing complications in the group ages 1-3 years old versus all other age patients was found to be statistically insignificant (OR 0.90, 95% CI 0.61 to 1.32, p = 0.58). The odds ratio of developing a complication after bilateral implantation compared to unilateral implantation was statistically significant (OR 1.96, 95% CI 1.18 to 3.28, p = 0.01). There was no difference in complication rates when comparing lateral wall and perimodiolar insertions. A total of 6 of 579 (1%) cochlear implants resulted in a complication requiring unplanned medical attention.


CONCLUSIONS
Overall, this series offers a decade of experience in pediatric cochlear implantation that shows a low incidence of the need for unplanned medical attention in the immediate postoperative period. The most common complication seen is Post-operative nausea and vomiting (PONV) that appears to be amenable to outpatient management even in the youngest populations. This supports providers routinely performing pediatric cochlear implantation on an outpatient basis.
University of Texas Health Science Center at San Antonio, Department of Otolaryngology-Head and Neck Surgery, San Antonio, TX, USA. Electronic address: sivam@uthscsa.edu.
Sunthosh K
SK
Sivam
University of Texas Health Science Center at San Antonio, Department of Otolaryngology-Head and Neck Surgery, San Antonio, TX, USA; Ear Medical Group, San Antonio, TX, USA.
Charles A
CA
Syms
University of Texas Health Science Center at San Antonio, Department of Otolaryngology-Head and Neck Surgery, San Antonio, TX, USA; Ear Medical Group, San Antonio, TX, USA.
Susan M
SM
King
University of Texas Health Science Center at San Antonio, Department of Otolaryngology-Head and Neck Surgery, San Antonio, TX, USA; Ear Medical Group, San Antonio, TX, USA.
Brian P
BP
Perry
D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003638:Deafness / Q000534:rehabilitation*; D004244:Dizziness / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D012189:Retrospective Studies; D015837:Vestibular Diseases / Q000453:epidemiology*
Complications; Outpatient procedure; Pediatric cochlear implant