A retrospective cohort study of adverse event assessment during anesthesia-related proceduresfor cochlear implant candidacy assessment and cochlear implantationin infants and toddlers.
Cochlear implantation in childrenwith sensorineural hearing loss is preferably performed at youngest age because early auditory input is essential to prevent neural plasticity decline. In contrast, the rate of anesthetic adverse events is increased during infancy. Therefore, to provide recommendations regarding an optimal pediatric implantation age, these possible anesthetic risks in infants need to be taken into account.This study aimed at assessing the relation between the age at cochlear implant surgery and anesthetic and surgical adverse events. Secondary aims were to evaluateanesthetic and surgical adverse events in relation to: 1) the number of preoperative anesthesia-related procedures for cochlear implant candidacy assessmentand 2) the anesthetic maintenance agent (total intravenous anesthesia versus inhalation anesthesia) during implantation.We executed aretrospective cohort study to evaluate cochlear implantation performed in infants and toddlers between January 2008 and July 2015in a tertiary pediatric center. We compared anesthetic and surgical adverse events between age-at-implantation (0-12 and 12-24 months of age) groups.Furthermore, we assessed whether anesthetic adverse events occurred during preoperative anesthesia-related procedures for cochlear implant candidacy assessment.Forty-six cochlear implantations were performed in 43 patients requiring 42preoperative anesthesia-related procedures. Nineteen cochlear implantations (41.3%) were performed during infancy. During implantation, the maintenance agent was either sevoflurane (n=22) or propofol (n=24).None of the patients encountered majoranestheticadverse events, whereas minor adverse events occurred during 34 cochlear implantations. Those attributed to surgery occurred followingsiximplantations. Neither the age at implantation nor the anesthetic maintenance agent was significantly related to the occurrence of both types of adverse events.Adverse events occur independent of the age at implantation,the number of anesthetic preoperative procedures and the type of anesthetic maintenance agent in patientswho received a cochlear implant before 24 months of age.