Socio-demographic profile and its influences on rehabilitation in children undergoing revision cochlear implantation – MERF experience

Abstract Introduction Revision cochlear implant surgery (RIS) is an unusual and unfortunate event, but not an uncommon occurrence in today's time, with more and more children being implanted. It is accepted that a pediatric cochlear implant recipient may require one or two revision procedures during their lifetime. The indication of RIS can be due to a multitude of causes like trauma, device failure (hard failure or soft failure), infection at the implant site, electrode extrusion, device migration, magnet migration, and upgradation in the technology. Scenarios, where the child is deprived of hearing once again is worrisome for the family. And, they need financial and psychological assistance as well. Aims and objectives (1) To scrutinize the socio-demographic profile of children who underwent RIS. (2)To profile the social, intellectual, and economic backgrounds of these families. Material and methods A retrospective, observational, non-interventional, cohort study conducted at the Implantation otology department of Madras ENT Research Foundation (MERF), Chennai, Tamil Nadu, India. Data collection: (1) Detailed medical records of all the children who satisfied the inclusion criteria were reviewed.(2)This was followed up by a telephonic interview with the guardian of the consenting patients, to obtain further data based on a customized questionnaire. Sample size: Of the 99 children who underwent RIS, 80 families consented to be part of the study. Statistical analysis:(1) Cause of revision implant surgery and Family system Risk estimate.(2) Correlation of sex, family system, patient non-compliance to habilitation, and residential area with RIS.(3) Correlation of the residential area of the patient with completion of 1-year habilitation. Results A significant association observed between RIS and Sex (P = 0.03). A significant co-relation between patient non-compliance to habilitation and cause of revision implant surgery observed (P = 0.02). A significant co-relation was seen between residential area (Rural/Urban) and cause of RIS (P = 0.02). A statistically significant correlation seen with the residential area (Rural/Urban) of the child and completion of 1-year habilitation (P = 0.01). Uni-variant association was found between patients that have completed one year of habilitation, patient compliance, and modified Kuppuswamy Socio-Economic status. Conclusion The current data has aided in refining our institutional management protocols and predicting high-risk candidates who may need revision surgery in the future. Based on the data, all cochlear implantees and their families especially in the lower socio-economic strata, are now being meticulously educated about device care, the possible reasons for failures, and the importance of timely re-intervention.