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Cochlear Implant Failure - Reimplantation and Extrusion

Sometimes the Implant Has to Be Removed

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Updated April 16, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

It fortunately does not happen that often, but it does happen - there may be cochlear implant failure. 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.com 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)
  • Head trauma
  • 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?

All cochlear implant 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 Product Problem "Malfunction" and Product Class "Implant, Cochlear," did not turn up any results as of November 2010.

Studies give an idea of how frequently reimplantation takes place.

  • In one study of 500 implant recipients at one implant center between 1989 and 2006, 51 out of the 500 (10.2%) had to have revision surgery.
  • In another study of 720 patients in South Korea between 1990 and 2007, 30 (4.2%) had to have revision surgery. Of these, 12 were reimplanted.

Additional Resources

There is a Yahoo groups discussion list on problems with cochlear implants, ProblemCI.

More About.com Readers on Cochlear Reimplantion

In addition to the About.com reader quoted above, other About.com readers have also written to About.com about their experiences with implant failure:

From a parent:"My son recently was reimplanted after the implant was found to be failing. We found out his implant was failing in the 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."
From an implanted adult:"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.

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."

From another parent: "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.

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 advice 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 (bilateral) 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."

On the day of my own cochlear implant surgery, there was a young boy about eight in the pre-op room. I was told he was having a cochlear implant reimplanted because his first one had failed. That made me nervous, but I went ahead with my surgery and hoped for the best.

Sources:

Clinical Outcomes of Cochlear Reimplantation Due to Device Failure. Clin Exp Otorhinolaryngol. 2008 March; 1(1): 10–14. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671756/. Accessed November 2010.

Reliability and Complications of 500 Consecutive Cochlear Implantations. Arch Otolaryngol Head Neck Surg. 2008;134(12):1276-1281. http://archotol.ama-assn.org/cgi/content/full/134/12/1276. Accessed November 2010.

Readers Respond: Cochlear Implant Failure Experiences

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