Revision Cochlear Implant Surgery: Speech Performance Outcomes at a Large Tertiary University Hospital

יפעת יער-סופר ^1,2 Doron Sagiv ^3,4 Ziva Yakir ¹ Michael Wolf ^3,4 Yisgav Shapira ^3,4 Yael Henkin ^1,2

¹Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer
²Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University
³The Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel Hashomer
⁴Sackler Faculty of Medicine, Tel Aviv University

Background: The number of cochlear implantations is growing due to expanded candidacy criteria and the continuous increase in life expectancy. These trends, together with longer periods of device use by cochlear implant (CI) recipients, result in increased prevalence of revision cochlear implant (RCI) surgery.

Objective: The goal of the current study was to evaluate the effect of RCI on speech perception performance by means of a within-subject analysis.

Method: We reviewed the medical records of all patients that underwent RCIs since the initiation of the Sheba CI program in 1989 through 2016. Data extracted included background variables, surgical reports, medical follow-up, and audiological evaluations.

Results: During the study period, 1,299 CI surgeries in 890 patients were performed (65% children, 35% adults). Of these, 153 surgeries (11.8%) in 134 patients (78% children, 22% adults) were RCI for various indications. 8.9% of the patients underwent more than one RCI surgery. Group mean speech perception performance was similar before and after RCI for open set monosyllabic words, phonemes, and SRTs. Within subject analysis of 118 cases with full datasets revealed that post RCI speech perception performance was unchanged in 65.3%, improved in 17.8%, and deteriorated in 16.9% of patients, based on a clinically significant change criterion. In the remaining cases datasets were incomplete.

Conclusion: The Sheba RCI rate is similar to previously reported rates. Within-subject comparisons indicated that speech perception performance was unchanged or improved in the majority of patients.