Cochlear Implantation in Infants: Evidence of Safety.
Nicholas L Deep, Patricia L Purcell, Karen A Gordon and 3 others
PMID 34028328WHAT IT FOUND
Cochlear implantation in infants under 1 year is safe when performed by experienced surgeons and pediatric anesthesiologists.
Major complications occurred in 2.9% of ears, mostly infections manageable with treatment. No meningitis or device failures were seen. Anesthesia risks were minimal.
Key findings
01The rate of major surgical complications was 2.9% across 242 implanted ears, with no cases of meningitis or device failure.
02There were no major complications related to anesthesia, and hypothermia occurred in 5.9% of cases but resolved with warming blankets.
03Complication rates did not significantly differ between infants younger than 9 months and those aged 9 to 11 months.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is retrospective, relying on electronic medical records which may contain inaccuracies or incomplete data. There was no control group of older children; comparisons were made against historical data from other studies. Follow-up was limited to 6 months, so complications arising later in life were not captured. Blood loss was estimated subjectively from operative notes rather than measured objectively. For bilateral cases, it was not possible to determine which ear developed an infection first due to reporting inconsistencies.
Declared interests
One author is a consultant for Cochlear Pty Limited, the manufacturer of the implants used. Several authors receive research support, though the funding source for this specific study is not explicitly detailed beyond the declaration of interests.
The easy way to misread this
Do not interpret these results as evidence that cochlear implantation is safe in infants under 1 year without an experienced pediatric anesthesiologist and specialized surgical team. The study included only cases managed by such experts, and the authors note that this expertise likely contributed to the low complication rate. Generalizing these safety outcomes to less specialized settings may be misleading.