Cochlear Implant Revisions Over Three Decades of Experience

ImportanceThe indications, technology, and surgical technique for cochlear implantation have evolved over the last three decades. Understanding the risk of cochlear implant revision (CIR) is important for patient counseling.ObjectiveThe objective of this study was to analyze the rates, indications, and audiologic outcomes for CIR over three decades of experience at a single academic medical center.DesignA retrospective chart review was performed at a single academic medical center for individuals who underwent cochlear implantation between 1985 and 2022.SettingSingle academic medical center.ParticipantsThree thousand twenty-five individuals who underwent 3,934 cochlear implant operations from 1985 to 2022.ExposureCochlear implantation.Main Outcomes and MeasuresRates, indications, risk factors, and audiologic outcomes for CIR.ResultsThere were 276 cases of CIR after primary implantation and an overall revision rate of 7.6% (95% confidence interval, 6.8-8.5%) over 37 years of follow-up with many cases of CIR secondary to Advanced Bionics vendor B and field action failure groups. CIR rates increased sharply through the early and mid-2000s and have since remained stable. Hard or soft device failure was the most common indication for CIR, accounting for 73% of cases. Pediatric patient status and previous CIR were associated with an increased risk of CIR. Audiologic outcomes after CIR were similar to those before device failure.Conclusions and RelevanceCIR remains a common procedure most often performed for device failure. Pediatric patients and those who have undergone previous CIR are at the highest risk for future CIR. Audiologic outcomes remain stable after CIR, and these data will help providers counsel patients at the risk of future CIR and understand the risk factors associated with CIR.