Postoperative Früh- und Spätkomplikationen bei Kindern und Erwachsenen nach CI-Implantation

 

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Zusammenfassung

Hintergrund: Cochlea-Implantate (CI) haben in den letzten 20 Jahren Einzug in die Regelversorgung sowohl bei congenital gehörlosen Kindern, bei ertaubten Kindern und Erwachsenen erhalten. Der Erfolg des Sprachverstehens bei Erwachsenen ist so ausgezeichnet, dass ein verbessertes Sprachverstehen im Geräusch auch bei einseitig Normalhörenden mit dem CI erreicht wird. Bei früh implantierten Kindern wird eine Hör-Sprachentwicklung erreicht, die der normalhörender Kinder vergleichbar ist. Dennoch ist dieses operative Verfahren, nämlich die Implanta­tion eines Fremdkörpers in einen nicht sterilen Raum, mit Komplikationen verbunden.

Material und Methoden: Die vorliegende Untersuchung dokumentiert die aufgetretenen Komplikationen in einem Patientenkollektiv, implantiert über einen Zeitraum von 21 Jahren. Unterteilt in den Schweregrad der Komplikation nach Behandlungsausmaß (konservativ bis operativ) konnte gezeigt werden, dass die Auftretenswahrscheinlichkeit von schweren perioperativen Komplikationen in der 2. Dekade im Vergleich zur ersten Dekade von 3,92% auf 1,8% gesenkt werden konnte. Auch haben die Hersteller gelernt, sichtbar an der sinkenden Zahl an Implantatdefekten.

Schlussfolgerung: Zusammenfassend konnte aufgezeigt werden, dass die uneingeschränkte nachhaltige postoperative Kontrolle und damit verbundene Modifikation von Therapiekonzepten zu einer Reduktion der Komplikationen ­führte.

Abstract

Complications in Children and Adults with Cochlear Implant

Background: Cochlear Implants (CI) are developed in the last 20 years to a regular therapy in congenital deaf children/newborns and deafened teens and adults. The success of speech understanding with the CI in adults is so extraordinary that meanwhile also unilateral deaf, contralateral normal hearing persons are implanted. In case of early implanted children a nearly normal speech development is possible in most of the cases.

Material und Methods: Nevertheless the surgical procedures is a challenge concerning the potential complications combined with a foreign body, the CI, in a non-steril part of the ear.

Results:This paper reports on the complications in a patients collective, implanted within 21 years. Separated within the severity of the complications and their therapeutic consequences (conservative and surgical) it could be shown that the incidence of severe perioperative complications within the second decade could be reduced from 3.92% (first decade) to 1.8%. Also the companies have learned to construct the products more save.

Conclusion: In summary the reliable and complete postoperative control and the modification of therapy concepts leads to a constant reduction of complications.

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