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Pediatric Cochlear Implantation: Associated With Minimal Postoperative Pain and Dizziness

Birman, Catherine S.*†‡§; Gibson, William P. R.†‡∥; Elliott, Elizabeth J.*†

doi: 10.1097/MAO.0000000000000569
Cochlear Implants
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Objective To prospectively document the surgical pain, assessing analgesia use as a proxy, and postoperative dizziness in children over the first week after cochlear implantation.

Study Design Prospective.

Setting Tertiary referral hospital and cochlear implant program.

Patients Children aged 0 to 16 years inclusive undergoing cochlear implant surgery, who returned to see the primary surgeon for the postoperative 1-week follow-up appointment.

Interventions One-week postoperative collection of data via direct questioning of parents and children.

Main Outcome Measures Analgesia use, duration of analgesia use and dizziness (nil, slight, or moderate), type of surgery, and radiologic findings.

Results Data were available for 61 of 98 children aged 5 months to 15 years. Children underwent first side implant (n = 27), sequential second side implant (n = 15), bilateral simultaneous (n = 16), and explant reimplantation (n = 3). On average, children used paracetamol for only 1.9 days after discharge from the hospital. Longer average paracetamol use was associated with bilateral simultaneous surgery (3.3 d after discharge from the hospital) and also the younger age group of 0 to 12 months (3.2 d). Slight dizziness was reported by 8% of all children at 1 week postsurgery.

No child had marked dizziness or unsteadiness. Four children had large vestibular aqueducts on radiology scans, two (50%) of these children has slight unsteadiness at 1 week postoperatively.

Conclusion Our study shows cochlear implant surgery is well tolerated by children. This information enables better counseling of families and children considering cochlear implantation.

*Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney; †Sydney Children’s Hospital Network (Children’s Hospital at Westmead); ‡The Sydney Cochlear Implant Centre, NSW; §Department of Linguistics, Faculty of Human Sciences, Macquarie University; and ∥Sydney Medical School, University of Sydney, Australia

Address correspondence and reprint requests to: Catherine S. Birman, M.B.B.S., F.R.A.C.S., Suite 402, Macquarie University Clinic, 2 Technology Place, Macquarie University, NSW 2109, Australia; E-mail: Catherine.birman@health.nsw.gov.au

Elizabeth Elliott holds a Practitioner Fellowship from the National Health and Medical Research Council of Australia (No. 1021480).

The authors disclose no conflicts of interest.

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