Complications in cochlear implant surgery

Background: In a retrospective analysis we evaluated the complication rate in 697 patients after cochlear implantation between 1985 and 1995 (366 children, 331 adults; 604 Nucleus, 50 Clarion and 42 other implants). Results: Intraoperatively in 74 cases (10.6 %) total or partial cochlear obliteration was found, a CSF gusher occured in 7 cases. Minor complications such as seroma (8 adults), wound infections (14 patients), emphysema, and swelling were successfully treated with conservative methods and drugs. Seven (2.1 %) adults showed facial nerve palsy postoperatively with incomplete recovery only in 2 of them (0.6%). No permanent facial nerve palsy was observed in children. Cholesteatoma developed in 18 adults (5.4%), which was treated by revision surgery. Conclusions: In conclusion, cochlear implant surgery is a safe procedure with a low complication rate. However, Cochlear implantation should be performed by well experienced ear surgeons who can properly handle intraoperative and postoperative problems. The patients should be informed about the typical risks of ear surgery including implant removal due to infection or technical defects, facial nerve palsy, vertigo and, especially in adults, increased tinnitus.