Cochlear Reimplantation: Causes of Failure, Outcomes, and Audiologic Performance
Bibliographic record
Abstract
OBJECTIVES/HYPOTHESIS: To review Quebec's experience with cochlear reimplantation in adults and children and describe failure rates, causes of revision, surgical findings, and the impact of reimplantation on audiologic performances. STUDY DESIGN: Retrospective analysis of all 45 cochlear implant revision surgeries (43 reimplantations) performed on 16 adults and 25 children at the Centre Hospitalier Universitaire de Québec (Hôtel-Dieu de Québec) in Quebec City, between 1987 and 2005. METHODS: : Data on patient demographics, failure sources including review of manufacturer's investigation reports, surgical findings, and outcomes (electrode insertion, complications, and audiologic performances). RESULTS: Mean length of device use before explantation was 5.5 years and ranged from 3 months to 17 years. Explantation was related to documented hard failure (53.3%), traumatic device failure (13.3%, only in children), extrusion of electrode array or scalp flap infection (13.3%), a decrease in performance or soft failure (11.1%), intratemporal pathology (6.7%), and a perilymphatic fistula (2.2%). Overall revision rates of 8.0% and 5.4% were obtained for children and adults, respectively. Total device failure rates of 6.2% in children and 3.3% in adults were calculated. Failure rates decreased with each new generation of Nucleus devices. Perioperative complications were uncommon. A moderate amount of fibrosis was found in the cochlea lumen, and sometimes osteoneogenesis made the reinsertion challenging. Electrode reinsertion depth was mostly comparable with the initial surgery. Speech perception abilities were maintained after reimplantation. CONCLUSIONS: Management of implant failures, including revision surgeries, is becoming an increasingly important part of cochlear implant program activity. It appears more commonly in children because of trauma. Medical and audiologic outcomes are generally excellent. Revision implantation appears to be a safe and effective procedure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".