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:
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."
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"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.
<DIV>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."</DIV><DIV></DIV><DIV>---</DIV><DIV>"My friend informed me that she cannot have her CI removed because it is 10 years old and too dangerous of a medical operation</DIV><DIV></DIV
DIV>(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. She is trapped with a hole in the side of her head and aging technology. This says nothing about the psychological scares she must live with. Where is the medical research on the long term negative impacts of this technology? Children and parents must have informed choice...the good, the bad and the ugly facts... "</DIV><DIV></DIV><DIV>---</DIV><DIV></DIV><DIV>"I have a 7 yr old boy who progressively lost hearing until deafened at age 4 years. He was implanted with Nucleus 24 via surgical "C-cut" on scalp. Shortly after surgery, incision became infected. Antiobitics appeared to clear it up. Had trouble with chronic scalp swelling over internal device for one year. The device became exposed. Had surgery to try to repair. Swelling problem continued. Culture revealed methicillan resistant staph aureous (MRSA) infection which is usually contracted in hospitals. CI was explanted.</DIV><DIV></DIV><DIV>A month later another CI was implanted on opposite side of head. Then after another year, the original side of head was reimplanted. There have been no problems with the last 2 implants. My strong advise to anyone with a CI or ear infection is to INSIST on a pre-antibiotic regimen culture. Had I known this, I could have saved alot of hearing time for my boy. At present date, he has worn the 2nd implant for 1 1/2 years and the 3rd (bilatteral) implant for 5 months. He was still pretty much pre-lingual at the time of the 2nd implantation. It seemed as if he had to start over almost from scratch with receptive/expressive speech. Progress started showing up after 1 year of the second implant."</DIV
for hearing people s sake and make them more easier than Deaf chlidren to make it harder from audist attitude people Wow, what a very selfish and very unthoughtful!