Causes and Challenges Regarding Explantation and Reimplantation in Pediatric Cochlear Implant Surgery: A Retrospective Analysis

Background and Objectives: Cochlear implantation (CI) is a surgical procedure that offers significant benefits to individuals with sensorineural hearing loss, particularly in pediatric patients, as it can prevent long-term cognitive impairment. Despite the devices being designed for lifelong use, complications may necessitate explantation and subsequent reimplantation. Materials and Methods: Our retrospective study analyzes the incidence and causes of such procedures in pediatric CI patients over a period of 15 years, from May 2009 to June 2025. The study included patients aged between 8 months and 17 years, recording their age, the manufacturers of their first and second implants, the reasons for explantation and reimplantation, and the type of electrode array used during the second surgery. Results: During the study period, a total of 440 cochlear implantations were performed in our department. The primary causes of explantation in our study group were device hardware failures in 2.27% of cases, seromas over the implant body or antenna in 0.68% of cases, spontaneous extrusion in 0.22% of cases, and local trauma with electrode displacement in 0.22% of cases. The study confirmed that hardware failures were the most common reason for reimplantation, with an incidence influenced by the device manufacturer and the extent of trauma to the device. Surgical observations highlight the challenges regarding electrode reimplantation and available electrode choices for the surgeon. Conclusions: The use of superior materials and advanced research in manufacturing can enhance implant reliability and reduce the number of surgical procedures required in the long term for pediatric patients. Any type of electrode array can be utilized in reimplantations if meticulous surgical techniques are applied.