Frequency and reasons for cochlear implant explantation.

Introduction Cochlear implantation has increased dramatically over the last 30 years. Postoperatively, however, not every patient benefits equally from CI. Occasionally, discomfort outweighs audiometric benefit, leading patients to request definite explantation.

Methods Retrospective review of CI explantations at a university center between 2009 and 2022. Analysis of reasons, interval between implantation and explantation, speech understanding and causes of deafness.

Results A total of 69 CI explantations were performed. 16 of these were definite operations (23.2%). The average interval between implantation and explantation was 89.75 months. In most cases, several factors such as inadequate hearing impression (75%), pain (37.5%), recurrent infections (12.5%), dizziness (12.5%), or need for regular MRI examinations (6.25%) led to the decision to explant.

Discussion Reasons for definite explantation of CIs usually represent a combination of subjective lack of audiometric benefit and additive factors such as pain, recurrent infections, or dizziness. Often, concomitant complaints are much more pronounced, especially in patients with (subjectively) insufficient hearing rehabilitation, than in patients with more successful ones. Although some patients with absent speech understanding may benefit from awareness of environmental sounds, this group of patients is particularly at risk for developing postoperative complaints. Therefore, a realistic expectation regarding possible insufficient hearing rehabilitation should be communicated to patients preoperatively to prevent subsequent explantations.

Publication History

Article published online:
12 May 2023