Yisgav Shapira1,2, Yifat Yaar-Soffer3,4, Minka Hildesheimer3,4, Lela Migirov1,2, Yael Henkin3,4. 1. Department of Otolaryngology, Head and Neck Surgery, Tel Aviv University, Tel Aviv, Israel. 2. School of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Hearing, Speech and Language Center, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel. 4. Department of Communication Disorders , Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
OBJECTIVES/HYPOTHESIS: We describe pain around the receiver/stimulator [RS] presenting months to years after implantation. STUDY DESIGN: A retrospective chart review. METHODS: We performed a retrospective review of all cochlear implant recipients complaining of pain around their RS through the years 2009 through 2013, with a follow-up of at least 6 months. Excluded from the study were patients with an identifiable cause for their pain such as trauma, local infection, or skin breakdown. The therapy regimen and outcomes were reviewed. RESULTS: Thirty patients complained of delayed pain over their RS, representing 2.8% of 1,044 implantations performed at the Sheba Medical Center, Tel Hashomer, Israel, as of 2013. The time from implantation to the presentation of pain ranged from 3 months to 12 years. The pain was perceptible even when the external magnet and processor were not used, and was usually most obvious in specific points around the RS. Seventy-seven percent of our patients responded well to conservative therapy. Fifteen (50%) responded to prolonged antibiotic treatment. Five patients (17%) responded to antiinflammatories alone. One patient (3%) responded to deactivation of two electrodes. Six patients (20%) required reimplantation, after which the pain resolved in all. At explantation, no signs of infection, foreign body reaction, or obvious device damage were found. CONCLUSION: Delayed pain around the RS that is unrelated to use is a serious consequence of cochlear implantation, and in some cases, those necessitating reimplantation, should be considered a major complication. LEVEL OF EVIDENCE: 4.
OBJECTIVES/HYPOTHESIS: We describe pain around the receiver/stimulator [RS] presenting months to years after implantation. STUDY DESIGN: A retrospective chart review. METHODS: We performed a retrospective review of all cochlear implant recipients complaining of pain around their RS through the years 2009 through 2013, with a follow-up of at least 6 months. Excluded from the study were patients with an identifiable cause for their pain such as trauma, local infection, or skin breakdown. The therapy regimen and outcomes were reviewed. RESULTS: Thirty patients complained of delayed pain over their RS, representing 2.8% of 1,044 implantations performed at the Sheba Medical Center, Tel Hashomer, Israel, as of 2013. The time from implantation to the presentation of pain ranged from 3 months to 12 years. The pain was perceptible even when the external magnet and processor were not used, and was usually most obvious in specific points around the RS. Seventy-seven percent of our patients responded well to conservative therapy. Fifteen (50%) responded to prolonged antibiotic treatment. Five patients (17%) responded to antiinflammatories alone. One patient (3%) responded to deactivation of two electrodes. Six patients (20%) required reimplantation, after which the pain resolved in all. At explantation, no signs of infection, foreign body reaction, or obvious device damage were found. CONCLUSION: Delayed pain around the RS that is unrelated to use is a serious consequence of cochlear implantation, and in some cases, those necessitating reimplantation, should be considered a major complication. LEVEL OF EVIDENCE: 4.
Authors: Martin L Johansson; Tim G A Calon; Omar Omar; Furqan A Shah; Margarita Trobos; Peter Thomsen; Robert J Stokroos; Anders Palmquist Journal: Front Cell Infect Microbiol Date: 2021-03-30 Impact factor: 5.293