NEW YORK (Reuters Health) - Canadian researchers have found that over the last 20 years, three percent of deaf children who got cochlear implants at their hospital needed new ones because of technical problems.
Just a couple of those kids suffered a drop in hearing or speaking skills after the new devices were implanted, the team reported this week in Archives of Otolaryngology-Head & Neck Surgery.
The study’s senior author, Dr. Blake Papsin, said that despite the low rate of repeated implants in kids, most will need a new device put in at some point in their lives.
“When I talk to parents, I say, ‘Let’s talk about your first cochlear implant,’” said Papsin, director of the cochlear implant program at The Hospital for Sick Children in Toronto.
“It’s become pretty clear that these devices are unlikely, even though beautifully made, to last a lifetime,” he told Reuters Health. Including the surgery and follow-up visits, an implant costs about $50,000.
But the findings are still promising, he added. “People used to say the complication rate is higher in children, the failure rate is higher in children, and we found that that was not the case.”
His team’s study included 738 kids, most born hard of hearing because of genetics. Those kids all received a cochlear implant — a device that transmits sound directly to the auditory nerve — in at least one ear between 1990 and 2010. They had the procedures when they were an average of two or three years old.
During that time, the hospital treated 34 kids whose implants had stopped working and who needed surgery to put in a new device.
When the researchers took out the seven kids who got their original implant at another hospital, they found that just under three percent of the patients they treated with a first cochlear implant needed a second due to malfunctions. That was over an average of six years of using the devices.
Almost all of the kids who needed a new device implanted maintained or improved their hearing and speaking abilities after the second procedure. Just two had a significant drop in those skills.
“Once these things fail, replacing them does tend to get the kids’ hearing back to or close to where it was before the device failed,” said Dr. Josef Shargorodsky, who studies hearing problems at Massachusetts Eye and Ear Infirmary and Brigham and Women’s Hospital in Boston and wasn’t involved in the new study.
He told Reuters Health that the number of device failures seen in this study is lower than in most previous reports — possibly because cochlear implant technology is improving.
Papsin said that over the long run, almost all deaf kids will probably eventually need a new implant, but it’s hard to know whether the typical person will need just one or a few. He added that when he does a cochlear implant surgery now, much of his technique is guided by knowing that someone will probably be going in to that ear again in the future.
Complications of the implant procedures are rare, Papsin said, but include infections and damage to the devices. The implants and related surgeries are usually covered by insurance.
Papsin — who is on the speaker’s bureau of the Cochlear Americas Corporation, which markets cochlear implants — said that in general, getting an implant is a “life-transforming operation” for families that decide to do it.
While they don’t allow deaf kids to hear in the same way that other kids do, cochlear implants do mean they can go to regular schools, have normal conversations and listen to music, he said.
And parents can be confident that the devices are very safe, he concluded, and that even kids who need repeat surgeries do well.
More than 200,000 people have received cochlear implants, including about 70,000 in the United States. According to the Food and Drug Administration, they have been approved for commercial use in the U.S. since the mid-1980s.
SOURCE: bit.ly/vyFkwC Archives of Otolaryngology-Head & Neck Surgery, online December 19, 2011.