Cochlear implantation in China: review of 1,237 cases with an emphasis on complications.

Objective: The purpose of this study is to retrospectively review the complications of patients who underwent cochlear implantation at 51 hospitals in mainland China over a decade.

Methods: A retrospective analysis of 1,237 patients who underwent cochlear implantation from February 1998 to December 2008. The patients were reviewed for demographic information, type of hearing loss, abnormal findings on temporal CT scans, cochlear implant device, procedure time, and complications that included meningitis, hematoma (intracranial and extracranial), wound infection and implant extrusion, cerebrospinal fluid leak and facial palsy.

Results: A total of 1,237 patient records were identified, and pertinent clinical information was reviewed. Of the patients, 59.6% were male, and 98.9% were prelingually deaf. The most common etiologies of hearing loss were: ototoxicity (28.1%), non-syndromic congenital hearing loss (14.8%), and inner ear malformation (18.5%). Inner ear malformations included: enlarged vestibular aqueduct (9.4%), Mondini defect (5.4%), common cavity (2.8%), cochlear ossification (3.9%), round window dysplasia (0.4%), and narrow internal auditory meatus (1.2%). The most common intraoperative complications were: gusher (5%) and electrode kinking (2.3%). The most common postoperative complications were hematoma (1.7%), wound infection and implant extrusion (0.5%), and device failure (0.9%). No CSF leakage or permanent facial palsy occurred.

Conclusions: Cochlear implantation is a safe and reliable otosurgical procedure in China, and the rate of complications is similar to developed countries. Carefully preoperative preparation and standardization of the procedure are important for the development of cochlear implant programs in developing countries.