CC BY-NC-ND 4.0 · Semin Hear 2021; 42(04): 352-364
DOI: 10.1055/s-0041-1739368
Review Article

Mythbusters! The Truth about Common Misconceptions in Cochlear Implantation

Erika A. Woodson
1   Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio
,
Ksenia Aaron
1   Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio
,
Ahn Nguyen-Huynh
1   Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio
,
Jonathan Vargo
2   Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio
,
Sarah E. Mowry
2   Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio
3   Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
› Author Affiliations

Abstract

Cochlear implantation (CI) is the preferred method of hearing rehabilitation when patients cannot perform well with traditional amplification. Unfortunately, there are still significant misconceptions around this life-changing intervention. The goal of this article is to address some of the most common myths around CI surgery. After reading this article, the learner will be able to explain the utility of CI in patients with residual hearing and recognize that insurance coverage is widespread. The reader will be able to list common risks associated with this well-tolerated procedure including anesthetic risk and the risk of vestibular dysfunction. Additionally, the reader will be able to identify the significant positive impact of CI on patients' quality of life. Finally, the reader will identify that many patients can safely have an MRI scan after implantation, including nearly all contemporary recipients.

Disclosures

S.E.M.—Paid consultant for Cochlear Americas for educational content to their Web site, educational consultant to Stryker—reimbursed for travel expenses, paid consultant to OtoMed. Other authors have no disclosures.




Publication History

Article published online:
09 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Cochlear implants in adults and children. NIH Consens Statement 1995; 13 (02) 1-30
  • 2 Hodges AV, Schloffman J, Balkany T. Conservation of residual hearing with cochlear implantation. Am J Otol 1997; 18 (02) 179-183
  • 3 Fraysse B, Dillier N, Klenzner T. et al. Cochlear implants for adults obtaining marginal benefit from acoustic amplification: a European study. Am J Otol 1998; 19 (05) 591-597
  • 4 Gantz BJ, Turner CW. Combining acoustic and electrical hearing. Laryngoscope 2003; 113 (10) 1726-1730
  • 5 Gantz BJ, Dunn C, Oleson J, Hansen M, Parkinson A, Turner C. Multicenter clinical trial of the Nucleus Hybrid S8 cochlear implant: final outcomes. Laryngoscope 2016; 126 (04) 962-973
  • 6 Gantz BJ, Dunn CC, Oleson J, Hansen MR. Acoustic plus electric speech processing: long-term results. Laryngoscope 2018; 128 (02) 473-481
  • 7 FDA Access Data. 27.8. Accessed May 31, 2021 at: https://www.accessdata.fda.gov/cdrh_docs/pdf/p000025s084b.pdf
  • 8 FDA Access Data. 26.7. Accessed May 31, 2021 at: https://www.accessdata.fda.gov/cdrh_docs/pdf13/p130016a.pdf
  • 9 Turner CW, Reiss LAJ, Gantz BJ. Combined acoustic and electric hearing: preserving residual acoustic hearing. Hear Res 2008; 242 (1-2): 164-171
  • 10 Karsten SA, Turner CW, Brown CJ, Jeon EK, Abbas PJ, Gantz BJ. Optimizing the combination of acoustic and electric hearing in the implanted ear. Ear Hear 2013; 34 (02) 142-150
  • 11 Tejani VD, Brown CJ. Speech masking release in Hybrid cochlear implant users: roles of spectral and temporal cues in electric-acoustic hearing. J Acoust Soc Am 2020; 147 (05) 3667
  • 12 Woodson EA, Reiss LAJ, Turner CW, Gfeller K, Gantz BJ. The Hybrid cochlear implant: a review. In: Cochlear Implants and Hearing Preservation. KARGER; 2009. DOI: 10.1159/000262604
  • 13 Balkenhol T, Wallhäusser-Franke E, Rotter N, Servais JJ. Cochlear implant and hearing aid: objective measures of binaural benefit. Front Neurosci 2020; 14: 586119
  • 14 Gifford RH, Dorman MF, Skarzynski H. et al. Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments. Ear Hear 2013; 34 (04) 413-425
  • 15 Parkinson AJ, Rubinstein JT, Drennan WR, Dodson C, Nie K. Hybrid music perception outcomes: implications for melody and timbre recognition in cochlear implant recipients. Otol Neurotol 2019; 40 (03) e283-e289
  • 16 Gfeller KE, Olszewski C, Turner C, Gantz B, Oleson J. Music perception with cochlear implants and residual hearing. Audiol Neurotol 2006; 11 (1, Suppl 1): 12-15
  • 17 Woodson E, Smeal M, Nelson RC, Haberkamp T, Sydlowski S. Slim perimodiolar arrays are as effective as slim lateral wall arrays for functional hearing preservation after cochlear implantation. Otol Neurotol 2020; 41 (06) e674-e679
  • 18 Mamelle E, Granger B, Sterkers O. et al. Long-term residual hearing in cochlear implanted adult patients who were candidates for electro-acoustic stimulation. Eur Arch Otorhinolaryngol 2020; 277 (03) 705-713
  • 19 Adunka OF, Gantz BJ, Dunn C, Gurgel RK, Buchman CA. Minimum reporting standards for adult cochlear implantation. Otolaryngol Head Neck Surg 2018; 159 (02) 215-219
  • 20 Spitzer ER, Waltzman SB, Landsberger DM, Friedmann DR. Acceptance and benefits of electro-acoustic stimulation for conventional-length electrode arrays. Audiol Neurotol 2021; 26 (01) 17-26
  • 21 Ludwig S, Riemann N, Hans S. et al. Evaluation of hearing preservation in adults with a slim perimodiolar electrode. Eur Arch Otorhinolaryngol 2021; ; (ePub ahead of print) DOI: 10.1007/s00405-021-06755-z.
  • 22 Sorkin D. Cochlear implant insurance. Accessed May 25, 2021 at: https://www.acialliance.org/page/HealthIns
  • 23 Neguse J. Ally's Act - HR 477. US House of Representatives. 2021 . Accessed May 25, 2021 at: https://www.congress.gov/bill/117th-congress/house-bill/477
  • 24 Rundshagen I. Postoperative cognitive dysfunction. Deutsches Aerzteblatt Online. Published online February 21, 2014. DOI: 10.3238/arztebl.2014.0119
  • 25 Coelho DH, Yeh J, Kim JT, Lalwani AK. Cochlear implantation is associated with minimal anesthetic risk in the elderly. Laryngoscope 2009; 119 (02) 355-358
  • 26 Carlson ML, Breen JT, Gifford RH. et al. Cochlear implantation in the octogenarian and nonagenarian. Otol Neurotol 2010; 31 (08) 1343-1349
  • 27 Spitzer ER, Waltzman SB. Outcomes of cochlear implantation in adults over 85 years of age. Cochlear Implants Int 2021; 22 (05) 296-302
  • 28 Eshraghi AA, Rodriguez M, Balkany TJ. et al. Cochlear implant surgery in patients more than seventy-nine years old. Laryngoscope 2009; 119 (06) 1180-1183
  • 29 Toner JG, John G, McNaboe EJ. Cochlear implantation under local anaesthesia, the Belfast experience. J Laryngol Otol 1998; 112 (06) 533-536
  • 30 Dietz A, Wüstefeld M, Niskanen M, Löppönen H. Cochlear implant surgery in the elderly: the feasibility of a modified suprameatal approach under local anesthesia. Otol Neurotol 2016; 37 (05) 487-491
  • 31 Pateron B, Bakhos D, LeLouarn A. et al. Local anaesthesia and conscious sedation for cochlear implantation: experience with 20 patients. J Laryngol Otol 2016; 130 (02) 151-156
  • 32 Shabashev S, Fouad Y, Huncke TK, Roland JT. Cochlear implantation under conscious sedation with local anesthesia; safety, efficacy, costs, and satisfaction. Cochlear Implants Int 2017; 18 (06) 297-303
  • 33 Toner F, Jackson CP, Toner JG. How we do it: local anaesthetic cochlear implantation. Cochlear Implants Int 2013; 14 (04) 232-235
  • 34 Carlson ML. Cochlear implantation in adults. N Engl J Med 2020; 382 (16) 1531-1542
  • 35 Chen DS, Clarrett DM, Li L, Bowditch SP, Niparko JK, Lin FR. Cochlear implantation in older adults: long-term analysis of complications and device survival in a consecutive series. Otol Neurotol 2013; 34 (07) 1272-1277
  • 36 Wong DJY, Moran M, O'Leary SJ. Outcomes after cochlear implantation in the very elderly. Otol Neurotol 2016; 37 (01) 46-51
  • 37 Sorrentino T, Coté M, Eter E. et al. Cochlear reimplantations: technical and surgical failures. Acta Otolaryngol 2009; 129 (04) 380-384
  • 38 Balkany TJ, Hodges AV, Buchman CA. et al. Cochlear implant soft failures consensus development conference statement. Otol Neurotol 2005; 26 (04) 815-818
  • 39 Battmer R-D, Linz B, Lenarz T. A review of device failure in more than 23 years of clinical experience of a cochlear implant program with more than 3,400 implantees. Otol Neurotol 2009; 30 (04) 455-463
  • 40 Wang JT, Wang AY, Psarros C, Da Cruz M. Rates of revision and device failure in cochlear implant surgery: a 30-year experience. Laryngoscope 2014; 124 (10) 2393-2399
  • 41 Dutt SN, Ray J, Hadjihannas E, Cooper H, Donaldson I, Proops DW. Medical and surgical complications of the second 100 adult cochlear implant patients in Birmingham. J Laryngol Otol 2005; 119 (10) 759-764
  • 42 Schow B, Friedland DR, Jensen J, Burg L, Runge CL. Electrode failure and device failure in adult cochlear implantation. Cochlear Implants Int 2012; 13 (01) 35-40
  • 43 Rivas A, Marlowe AL, Chinnici JE, Niparko JK, Francis HW. Revision cochlear implantation surgery in adults: indications and results. Otol Neurotol 2008; 29 (05) 639-648
  • 44 Basavaraj S, Najaraj S, Shanks M, Wardrop P, Allen AA. Short-term versus long-term antibiotic prophylaxis in cochlear implant surgery. Otol Neurotol 2004; 25 (05) 720-722
  • 45 Gawęcki W, Karlik M, Borucki Ł, Szyfter-Harris J, Wróbel M. Skin flap complications after cochlear implantations. Eur Arch Otorhinolaryngol 2016; 273 (12) 4175-4183
  • 46 Gluth MB, Singh R, Atlas MD. Prevention and management of cochlear implant infections. Cochlear Implants Int 2011; 12 (04) 223-227
  • 47 Spitzer JB, Cellum IP, Bosworth C. Stability of audiometric measures and challenges in long-term management of the elderly cochlear implant patient. Otol Neurotol 2013; 34 (09) 1636-1641
  • 48 Brito R, Monteiro TA, Leal AF, Tsuji RK, Pinna MH, Bento RF. Surgical complications in 550 consecutive cochlear implantation. Rev Bras Otorrinolaringol (Engl Ed) 2012; 78 (03) 80-85
  • 49 Reefhuis J, Honein MA, Whitney CG. et al. Risk of bacterial meningitis in children with cochlear implants. N Engl J Med 2003; 349 (05) 435-445
  • 50 Centers for Disease Control and Prevention. Cochlear implants and vaccination recommendations. Published August 8, 2019. Accessed June 19, 2021 at: https://www-cdc-gov.laneproxy.stanford.edu/vaccines/vpd/mening/public/dis-cochlear-faq-gen.html
  • 51 Wei BPC, Robins-Browne RM, Shepherd RK, Clark GM, O'Leary SJ. Can we prevent cochlear implant recipients from developing pneumococcal meningitis?. Clin Infect Dis 2008; 46 (01) e1-e7
  • 52 Torkos A, Czigner J, Jarabin J. et al. Recurrent bacterial meningitis after cochlear implantation in a patient with a newly described labyrinthine malformation. Int J Pediatr Otorhinolaryngol 2009; 73 (01) 163-171
  • 53 Yoshikawa N, Hirsch B, Telischi FF. Cochlear implant fixation and dura exposure. Otol Neurotol 2010; 31 (08) 1211-1214
  • 54 Cohen NL, Roland Jr JT, Marrinan M. Meningitis in cochlear implant recipients: the North American experience. Otol Neurotol 2004; 25 (03) 275-281
  • 55 Fayad JN, Wanna GB, Micheletto JN, Parisier SC. Facial nerve paralysis following cochlear implant surgery. Laryngoscope 2003; 113 (08) 1344-1346
  • 56 Jeppesen J, Faber CE. Surgical complications following cochlear implantation in adults based on a proposed reporting consensus. Acta Otolaryngol 2013; 133 (10) 1012-1021
  • 57 Halawani R, Aldhafeeri A, Alajlan S, Alzhrani F. Complications of post-cochlear implantation in 1027 adults and children. Ann Saudi Med 2019; 39 (02) 77-81
  • 58 Alzhrani F, Lenarz T, Teschner M. Taste sensation following cochlear implantation surgery. Cochlear Implants Int 2013; 14 (04) 200-206
  • 59 Niparko JK, Oviatt DL, Coker NJ, Sutton L, Waltzman SB, Cohen NL. VA Cooperative Study Group on Cochlear Implantation. Facial nerve stimulation with cochlear implantation. Otolaryngol Head Neck Surg 1991; 104 (06) 826-830
  • 60 Cohen NL, Hoffman RA, Stroschein M. Medical or surgical complications related to the nucleus multichannel cochlear implant. Ann Otol Rhinol Laryngol 1989; 98 (09) 754
  • 61 Alzhrani F, Halawani R, Basodan S, Hudeib R. Investigating facial nerve stimulation after cochlear implantation in adult and pediatric recipients. Laryngoscope 2021; 131 (02) 374-379
  • 62 Mueller CA, Khatib S, Temmel AFP, Baumgartner W-D, Hummel T. Effects of cochlear implantation on gustatory function. Ann Otol Rhinol Laryngol 2007; 116 (07) 498-501
  • 63 Baguley DM, Atlas MD. Cochlear implants and tinnitus. Prog Brain Res 2007; 166: 347-355
  • 64 Ito J. Tinnitus suppression in cochlear implant patients. Otolaryngol Head Neck Surg 1997; 117 (06) 701-703
  • 65 Kloostra FJJ, Verbist J, Hofman R, Free RH, Arnold R, van Dijk P. A prospective study of the effect of cochlear implantation on tinnitus. Audiol Neurotol 2018; 23 (06) 356-363
  • 66 Kompis M, Pelizzone M, Dillier N, Allum J, DeMin N, Senn P. Tinnitus before and 6 months after cochlear implantation. Audiol Neurotol 2012; 17 (03) 161-168
  • 67 Baguley D. New insights into tinnitus in cochlear implant recipients. Cochlear Implants Int 2010; 11: 3136
  • 68 McRackan TR, Bauschard M, Hatch JL. et al. Meta-analysis of quality-of-life improvement after cochlear implantation and associations with speech recognition abilities. Laryngoscope 2018; 128 (04) 982-990
  • 69 McRackan TR, Hand BN, Velozo CA, Dubno JR. Cochlear Implant Quality of Life Development Consortium. Cochlear implant quality of life (CIQOL): development of a profile instrument (CIQOL-35 Profile) and a global measure (CIQOL-10 Global). J Speech Lang Hear Res 2019; 62 (09) 3554-3563
  • 70 McRackan TR, Hand BN, Velozo CA, Dubno JR. Cochlear Implant Quality of Life Consortium. Validity and reliability of the Cochlear Implant Quality of Life (CIQOL)-35 Profile and CIQOL-10 Global instruments in comparison to legacy instruments. Ear Hear 2021; 42 (04) 896-908
  • 71 Eapen RJ, Buss E, Adunka MC, Pillsbury III HC, Buchman CA. Hearing-in-noise benefits after bilateral simultaneous cochlear implantation continue to improve 4 years after implantation. Otol Neurotol 2009; 30 (02) 153-159
  • 72 Laszig R, Aschendorff A, Stecker M. et al. Benefits of bilateral electrical stimulation with the nucleus cochlear implant in adults: 6-month postoperative results. Otol Neurotol 2004; 25 (06) 958-968
  • 73 Lane C, Zimmerman K, Agrawal S, Parnes L. Cochlear implant failures and reimplantation: a 30-year analysis and literature review. Laryngoscope 2020; 130 (03) 782-789
  • 74 Dorman MF, Natale SC, Butts AM, Zeitler DM, Carlson ML. The sound quality of cochlear implants: studies with single-sided deaf patients. Otol Neurotol 2017; 38 (08) e268-e273
  • 75 Prejban DA, Hamzavi J-S, Arnoldner C. et al. Single sided deaf cochlear implant users in the difficult listening situation: speech perception and subjective benefit. Otol Neurotol 2018; 39 (09) e803-e809
  • 76 Dorman MF, Cook Natale S, Baxter L, Zeitler DM, Carlson ML, Noble JH. Cochlear place of stimulation is one determinant of cochlear implant sound quality. Audiol Neurotol 2019; 24 (05) 264-269
  • 77 Hänsel T, Gauger U, Bernhard N. et al. Meta-analysis of subjective complaints of vertigo and vestibular tests after cochlear implantation. Laryngoscope 2018; 128 (09) 2110-2123
  • 78 Kubo T, Yamamoto K, Iwaki T, Doi K, Tamura M. Different forms of dizziness occurring after cochlear implant. Eur Arch Otorhinolaryngol 2001; 258 (01) 9-12
  • 79 Enticott JC, Tari S, Koh SM, Dowell RC, O'Leary SJ. Cochlear implant and vestibular function. Otol Neurotol 2006; 27 (06) 824-830
  • 80 Melvin T-AN, Della Santina CC, Carey JP, Migliaccio AA. The effects of cochlear implantation on vestibular function. Otol Neurotol 2009; 30 (01) 87-94
  • 81 Buchman CA, Joy J, Hodges A, Telischi FF, Balkany TJ. Vestibular effects of cochlear implantation. Laryngoscope 2004; 114 (10 Pt 2, Suppl 103): 1-22
  • 82 Ibrahim I, da Silva SD, Segal B, Zeitouni A. Effect of cochlear implant surgery on vestibular function: meta-analysis study. J Otolaryngol Head Neck Surg 2017; 46 (01) 44
  • 83 Abouzayd M, Smith PF, Moreau S, Hitier M. What vestibular tests to choose in symptomatic patients after a cochlear implant? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2017; 274 (01) 53-63
  • 84 Tien H-C, Linthicum Jr FH. Histopathologic changes in the vestibule after cochlear implantation. Otolaryngol Head Neck Surg 2002; 127 (04) 260-264
  • 85 Handzel O, Burgess BJ, Nadol Jr JB. Histopathology of the peripheral vestibular system after cochlear implantation in the human. Otol Neurotol 2006; 27 (01) 57-64
  • 86 Mukherjee P, Eykamp K, Brown D. et al. Cochlear implantation in Ménière's disease with and without labyrinthectomy. Otol Neurotol 2017; 38 (02) 192-198
  • 87 Selleck A, Dillon M, Perkins E, Brown K. Cochlear implantation in the setting of Meniere's disease after labyrinthectomy: a meta-analysis. Otol Neurotol 2021; 42 (08) e973-e979
  • 88 Cochlear Americas. MRI guidelines for professionals. Accessed June 19, 2021 at: https://www.cochlear.com/us/en/professionals/resources-and-training/mri-guidelines
  • 89 Advanced Bionics LLC. MRI Safety Information. Accessed May 8, 2021 at: https://advancedbionics.com/us/en/portals/professional-portal/products/mri-safety.html
  • 90 MED-EL Corporation. Important Safety Information. Accessed May 8, 2021 at: https://www.medel.com/en-us/important-safety-information