Comparison of Adult and Pediatric Cochlear Implant Wound Complications: A Meta-Analysis

Brady Ekman, Jack Laureano, Beverly Balasuriya, Anthony Mahairas, Matthew L. Bush

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: To compare age-related differences in wound complications following cochlear implantation (CI). Methods: We performed a systematic review of PubMed, Cochrane Database, and Web of Science databases to identify original research evaluating the patient-level factors (demographics and medical history) associated with wound complications following CI. Outcomes were expressed as relative risk (RR) with 95% confidence intervals using the inverse variance method. Studies without comparison groups were described qualitatively. Results: Thirty-eight studies representing 21,838 cochlear implantations were included. The rate of wound complications ranges from 0% to 22%. Patient age (adult versus pediatric) was the only factor with comparison groups appropriate for meta-analysis. The 10 studies (n = 9547 CI's) included in the meta-analysis demonstrated that adults had a higher incidence of overall wound complications (2.94%) than in children (2.44%) (RR 1.31, 95% CI 1.01–1.69). Adults had a higher incidence of general/unclassified wound complications (2.07%) than in children (1.34%) (RR 1.68, 95% CI 1.12–2.52). There was no difference between adults and children for specific complications such as hematoma, infection, or seroma. Elderly patients (over age 75) have wound complication rates that range from 1% to 4%. No studies contained comparison groups regarding other patient-level factors and CI wound complications. Conclusion: CI wound complication rates reported in the literature are low; however, adults have a higher risk of these complications than pediatric patients. The reported complication rate in elderly adults is low. There is a gap in CI research in consistently reporting wound complications and rigorous research investigating the impact of patient-level factors and wound complications. Level of Evidence: Not applicable Laryngoscope, 2022.

Original languageEnglish
JournalLaryngoscope
DOIs
StateAccepted/In press - 2022

Bibliographical note

Funding Information:
This study was supported by Guangdong Basic and Applied Basic Research Foundation (number 2022A1515011045), Science, Technology and Innovation Commission of Shenzhen Municipality under Grant (number JCYJ20190806152001762), National Natural Science Foundation of China (number 81373158), and Shenzhen Key Medical Discipline Construction Fund (number SZXK070). The authors thank allograft donors and the recipients who received liver transplantation for generously providing blood samples for this study.

Funding Information:
Guangdong Basic and Applied Basic Research Foundation, Grant/Award Number: 2022A1515011045; National Natural Science Foundation of China, Grant/Award Number: 81373158; Science, Technology and Innovation Commission of Shenzhen Municipality, Grant/Award Number: JCYJ20190806152001762; Shenzhen Key Medical Discipline Construction Fund, Grant/Award Number: SZXK070 Funding information

Publisher Copyright:
© 2022 The American Laryngological, Rhinological and Otological Society, Inc.

Keywords

  • cochlear implantation
  • meta-analysis
  • systematic review
  • wound complications

ASJC Scopus subject areas

  • Otorhinolaryngology

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