Pediatric Cochlear implant soft failure

David Ulanovski, Joseph Attias, Meirav Sokolov, Tali Greenstein, Eyal Raveh

Research output: Contribution to journalArticlepeer-review


Purpose: Hard cochlear implant failures are diagnosed by objective tests whereas soft failures are suspected on the basis of clinical signs and symptoms. This study reviews our experience with children in tertiary pediatric medical center who underwent revision cochlear implantation, with emphasis on soft failures. Materials and methods: Children (age < 18 years) who underwent revision cochlear implantation from 2000 to 2012 were identified by database search. Pre- and post-explantation data were collected. Results: Twenty-six revision surgeries were performed, accounting for 7.4% of all cochlear implant surgeries at our center during the study period. The pre-explantation diagnosis was hard failure in 7 cases (27%), soft failure in 12 (46%), and medical failure in 7 (27%). On post-explantation analysis, 7/12 devices from the soft-failure group with a normal integrity test had abnormal findings, yielding a 63% false-negative rate (12/19) for the integrity test. All children regained their initial performance. Compared to hard failures, soft failures were associated with a shorter median time from first implantation to symptom onset (8 vs 25 months) but a significantly longer time from symptom onset to revision surgery (17.5 vs 3 months; P = 0.004). Conclusions: Soft cochlear implant failure in young patients poses a diagnostic challenge. A high index of suspicion is important because a delayed diagnosis may have severe consequences for language development. A normal integrity test does not unequivocally exclude device failure and is unrelated to functional outcome after revision surgery. Better education of parents and rehabilitation teams is needed in addition to more accurate diagnostic tests.

Original languageEnglish
Pages (from-to)107-110
Number of pages4
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number2
StatePublished - 1 Mar 2018

Bibliographical note

Publisher Copyright:
© 2017 Elsevier Inc.


  • Cochlear implant
  • Hard failure
  • Soft failure

ASJC Scopus subject areas

  • Otorhinolaryngology


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