sometimes the implant has to be removed
It fortunately does not happen that often, but it does happen. Sometimes a newly implanted cochlear implant must be surgically removed. The implantee may get a new implant, or no new implant at all, depending on the reasons for the removal. One mother wrote to About and described what had happened to her child:
Child had to have cochlear removed because the incision would never heal properly.
The implant itself was a success and child was able to hear. Child and sibling both had the CI done. After 2 weeks [sibling] had healed perfectly and [child] had yet to heal completely. When the troubled area would finally heal [child] would have problems in another spot. They tried plastic surgery twice, attempting to close the wound. Both times were unsuccessful and the doctors could not figure out why it wouldn't heal. Finally, when the wound became so bad that about 1/3 of the CI was actually exposed the only option we had was to have it removed. In the 13 months that [child] had the implant she had only been able to use it about 5 months. I do not regret having the surgery done because the pros outweighed the cons by far. Unfortunately it didn't work as we had hoped.
Why Reimplant a Cochlear Implant?
There are several reasons that a cochlear implant may have to be removed. Among them:
How Frequent Is Reimplantation?
According to CochlearImplant.org (a website about insurance and cochlear implants), "approximately two percent of all cochlear implant devices experience device failure" and have to be removed (explanted). All device failures must be reported to the Food and Drug Administration (FDA).
The FDA has a searchable online database, MAUDE, that lists cochlear implant device failures. A quick search on event type Malfunction turned up these results for reports submitted from 2001-2002 (by Dec. 31, 2002): Cochlear Nucleus 22: 249 records. Cochlear Nucleus 24: 227 records. Med-El Combi 40: 16 records. Advanced Bionics Clarion: 215 records.
Additional examples:
In a study of 10 implantees in Sweden, one had to have the implant removed due to infection.
In another study in Australia (Explantation and re-implantation in children and adults: the Melbourne experience, a presentation made at the 1999 Conference on Implantable Auditory Prostheses), it was noted that "4 percent of total surgeries [were] performed due to device failure."
In web searching, I came across several examples of adults and children whose implants had to be removed because of infection or device failure. Most were able to do well with new implants.
Additional Resources
The issues of reimplantation and extrusion have been addressed in a variety of published resources:
A book, J. Thomas Roland Jr., "Complications of Cochlear Implant Surgery".
An article, Cochlear reimplantation: surgical techniques and functional results, in Laryngoscope, vol 111, pp 1608-1613.
An article, " Outcome analysis of cochlear implant reimplantation in children, " in Laryngoscope, vol 111, pp. 26-32.
There is also a discussion list on problems with cochlear implants, ProblemCI.
Have you experienced extrusion or needed reimplantation? Was reimplantation successful? Submit your story for addition to this article and read others' submissions below.
"My son recently was reimplanted after the implant was found to be failing. We found out his implant was failing inthe anniverary month of him being implanted 3 years. He was able to progress even though his implant was failing. He was reimplanted and the difference is night and day. Within three weeks he has regained anything he lost when he wasn't hooked up and even gaining. The surgery was actually easier on him than the first time. He is so excited about having his implant back, functional."
----
"I'm a congenitally deaf woman who received a cochlear implant six years ago. Although my CI was functioning fine, the receiver had extruded and migrated so that it was pressing uncomfortably against my earlobe. Two months ago, I had surgery to reposition this CI. Unfortunately, the electrode array slipped out of the cochlea into the middle ear during surgery. Also, it is quite possible that the device also failed. When I first turned on my speech processor after the incision had healed, I received painful electrical shocks instead of hearing sounds. I'm scheduled for another surgery to replace my CI with the latest CI model.
I sure hope that this new CI will be successful because I would be really upset about going through the agony of another surgery and facing the disappointment of yet another CI failure."
"My friend informed me that she cannot have her CI removed because it is 10 years old and too dangerous of a medical operation (to have an implant removed). Does this mean she must live with the older CI technology?
What about young adults whose parents made the decision to this technology implanted, were the parties informed that removing an implant 10 years later would be dangerous and not recommended by the medical profession? How many thousands of children are trapped living with older generation technology in thier heads that is extremely dangerous to remove due to nerve growth around the implant? My friend was very saddened when she learned that at her present age, her doctor's were strongly against replacing her older CI with a newer CI due to the high probability of threat to her health and well being.
http://deafness.about.com/cs/cochlearfeatures/a/reimplantation.htm
It fortunately does not happen that often, but it does happen. Sometimes a newly implanted cochlear implant must be surgically removed. The implantee may get a new implant, or no new implant at all, depending on the reasons for the removal. One mother wrote to About and described what had happened to her child:
Child had to have cochlear removed because the incision would never heal properly.
The implant itself was a success and child was able to hear. Child and sibling both had the CI done. After 2 weeks [sibling] had healed perfectly and [child] had yet to heal completely. When the troubled area would finally heal [child] would have problems in another spot. They tried plastic surgery twice, attempting to close the wound. Both times were unsuccessful and the doctors could not figure out why it wouldn't heal. Finally, when the wound became so bad that about 1/3 of the CI was actually exposed the only option we had was to have it removed. In the 13 months that [child] had the implant she had only been able to use it about 5 months. I do not regret having the surgery done because the pros outweighed the cons by far. Unfortunately it didn't work as we had hoped.
Why Reimplant a Cochlear Implant?
There are several reasons that a cochlear implant may have to be removed. Among them:
- The skin flap can become infected.
- The body can reject the implant (as happened with the child above)
- The implant receiver can extrude.
- The electrode array can get damaged or the electrodes were not put in right. Or the electrode array can migrate out of place.
- The implant simply does not work right.
How Frequent Is Reimplantation?
According to CochlearImplant.org (a website about insurance and cochlear implants), "approximately two percent of all cochlear implant devices experience device failure" and have to be removed (explanted). All device failures must be reported to the Food and Drug Administration (FDA).
The FDA has a searchable online database, MAUDE, that lists cochlear implant device failures. A quick search on event type Malfunction turned up these results for reports submitted from 2001-2002 (by Dec. 31, 2002): Cochlear Nucleus 22: 249 records. Cochlear Nucleus 24: 227 records. Med-El Combi 40: 16 records. Advanced Bionics Clarion: 215 records.
Additional examples:
In a study of 10 implantees in Sweden, one had to have the implant removed due to infection.
In another study in Australia (Explantation and re-implantation in children and adults: the Melbourne experience, a presentation made at the 1999 Conference on Implantable Auditory Prostheses), it was noted that "4 percent of total surgeries [were] performed due to device failure."
In web searching, I came across several examples of adults and children whose implants had to be removed because of infection or device failure. Most were able to do well with new implants.
Additional Resources
The issues of reimplantation and extrusion have been addressed in a variety of published resources:
A book, J. Thomas Roland Jr., "Complications of Cochlear Implant Surgery".
An article, Cochlear reimplantation: surgical techniques and functional results, in Laryngoscope, vol 111, pp 1608-1613.
An article, " Outcome analysis of cochlear implant reimplantation in children, " in Laryngoscope, vol 111, pp. 26-32.
There is also a discussion list on problems with cochlear implants, ProblemCI.
Have you experienced extrusion or needed reimplantation? Was reimplantation successful? Submit your story for addition to this article and read others' submissions below.
"My son recently was reimplanted after the implant was found to be failing. We found out his implant was failing inthe anniverary month of him being implanted 3 years. He was able to progress even though his implant was failing. He was reimplanted and the difference is night and day. Within three weeks he has regained anything he lost when he wasn't hooked up and even gaining. The surgery was actually easier on him than the first time. He is so excited about having his implant back, functional."
----
"I'm a congenitally deaf woman who received a cochlear implant six years ago. Although my CI was functioning fine, the receiver had extruded and migrated so that it was pressing uncomfortably against my earlobe. Two months ago, I had surgery to reposition this CI. Unfortunately, the electrode array slipped out of the cochlea into the middle ear during surgery. Also, it is quite possible that the device also failed. When I first turned on my speech processor after the incision had healed, I received painful electrical shocks instead of hearing sounds. I'm scheduled for another surgery to replace my CI with the latest CI model.
I sure hope that this new CI will be successful because I would be really upset about going through the agony of another surgery and facing the disappointment of yet another CI failure."
"My friend informed me that she cannot have her CI removed because it is 10 years old and too dangerous of a medical operation (to have an implant removed). Does this mean she must live with the older CI technology?
What about young adults whose parents made the decision to this technology implanted, were the parties informed that removing an implant 10 years later would be dangerous and not recommended by the medical profession? How many thousands of children are trapped living with older generation technology in thier heads that is extremely dangerous to remove due to nerve growth around the implant? My friend was very saddened when she learned that at her present age, her doctor's were strongly against replacing her older CI with a newer CI due to the high probability of threat to her health and well being.
http://deafness.about.com/cs/cochlearfeatures/a/reimplantation.htm