Assessment and Investigation in Reimplantation of Cochlear Implant: Case Report
涂茱婷(Chu-Ting Tu)；劉冠麟(Guan-Lin Liu)；劉如芳(Ju-Fang Liu)
人工電子耳 ； 再植入術 ； 術後成效 ； 聽能復健 ； Cochlear implant ； Reimplantation ； Postoperative recovery ； Aural rehabilitation
|Volume or Term/Year and Month of Publication||
42期（2020 / 06 / 01）
81 - 90
Cochlear implantation has been established as a reliable and effective means of hearing rehabilitation in patients with hearing loss and poor speech discrimination. Recently improved device design and refined surgical technique has decreased the implant failure rate, but the life span of cochlear implants is now a critical issue. Symptoms of device failure most frequently involve abrupt and complete loss of auditory signal. Among pediatric patients requiring reimplantation for device failure, more than 85% have an identifiable cause (loss of hermeticity, case fracture, circuit failure, etc.), and only a small percent have unexplained device malfunction. Therefore, the reimplantation of cochlear implant is extremely important. This study focuses on the treatment effect reimplantation of a cochlear implant in the case of 3-year-old male patient who underwent cochlear implantation. Surgery was uneventful, and speech perception was initially excellent, but 15 years postoperatively the patient developed symptoms such as intermittent loss of hearing. This required reimplantation for circuit failure of the device. Although the patient did not proceed with hearing stimulation for 4 months, he experienced a rapid restoration in speech perception with the novel implant device and sound encoding reprogramming strategy. His speech perception at 2-month post-reimplantation reached the levels of his best performance with the initial device. Postoperative audiometric testing and sound field audiometry showed that hearing performance was dramatically better than before the operation. Moreover, we utilized a novel sound encoding strategy which provide the lower electric current to extend battery life, patients with the new devices and the novel sound encoding strategy demonstrate better hearing perception performance. Overall, reimplantation surgery is feasible and safe when previously functioning devices no longer have adequate audiological performance. The results showed an individual case goes through the reimplantation and auditory threshold tracking that had a substantial impact and improved the patients' quality of life.