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Re-implantation

Re-implantation. Infection 1% Device failure 3% ? inevitable. Re-implantation. Infection 1% Device failure 3% ? inevitable. Re-implantation. Basic technique (see handout) Book urgent replant (if unilateral CI user) Find RS Follow to fantail

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Re-implantation

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  1. Re-implantation • Infection 1% • Device failure 3% • ? inevitable

  2. Re-implantation • Infection 1% • Device failure 3% • ? inevitable

  3. Re-implantation • Basic technique (see handout) • Book urgent replant (if unilateral CI user) • Find RS • Follow to fantail • Follow arrays to cavity with keratotomy blade and annulus elevator under microscope • Explant ball electrode – surprisingly difficult under temporalis • Drill away new bone from mastoid • Usually facial recess is not re-ossified • Remove RS from under flap and place on retractor (use the magnet) • Insert new RS (+/- tie down) • Divide capsule around array at the cochleostomy • Explant array and insert replacement array

  4. Re-implantation • Tips • stage infected re-implantation • leave array in situ if possible • cochleostomy • cut capsule • insert new array immediately old array removed • beware electrode diameter

  5. Re-implantation • Tips • stage infected re-implantation • leave array in situ if possible • cochleostomy • cut capsule • insert new array immediately old array removed • beware electrode diameter

  6. Re-implantation outcome Grouped PBK word scores (n = 14) Speech perception = matched controls PBK word score p<0.0001 Pre-replant Post-replant Control

  7. Re-implantation: Summary • Re-implantation can be successful • How often? • Aim to prevent device failure

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