SLPMeta-AnalysisEar and hearing2022

Cochlear Reimplantation Rate and Cause: a 22-Year, Single-Center Experience, and a Meta-Analysis and Systematic Review.

Haotian Liu, Xinyi Yao, Weili Kong and 5 others

PMID 35973054

WHAT IT FOUND

4.7% of initial cochlear implants were replaced across 144 studies.

Device failure accounted for 67.6%. Most replacements were in the same ear. Long-term hearing and speech outcomes were rarely assessed.

Key findings

01The meta-analysis included 144 studies, 85,851 initial cochlear implants, and 4276 reimplanted cochlear implants.

02The combined reimplantation rate was 4.7%, device failure accounted for 67.6% of reimplantations, and 85.5% were ipsilateral.

03At the single center, the reimplantation rate was 3.3%, with 78.9% due to device failure and 91.2% ipsilateral.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The meta-analysis combined studies from different regions, populations, time periods, and calculation methods, and heterogeneity was high (I2 92.0%). The authors did not assess study quality because a standard definition of cochlear reimplantation was lacking and common tools were not suitable. Publication bias was present: the funnel plot was not symmetrical and the Egger test showed P < 0.001. Only 68 of 144 studies (47.2%) evaluated reimplantation effect, and most follow-up was within one year. 26 articles with only one reimplantation reason were excluded, and the sample size was reduced. The single-center data are from one hospital and may not represent worldwide practice. Short follow-up may mean the reimplantation rates are underestimated. The authors called the reported reimplantation rate a rough estimate.

Declared interests

The authors declared no conflicts of interest. The review received no specific grant from public, commercial, or not-for-profit sectors.

The easy way to misread this

Do not read the 4.7% combined rate as a precise worldwide average. The studies varied very widely (I2 92.0%), publication bias was present, and the authors did not assess study quality. They called the reported rate a rough estimate.

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