Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-23T14:37:27.914Z Has data issue: false hasContentIssue false
  • English
  • Français

Local anaesthesia and conscious sedation for cochlear implantation: experience with 20 patients

Published online by Cambridge University Press:  01 December 2015

B Pateron ,
D Bakhos ,
A LeLouarn ,
P Bordure ,
A Bozorg Grayeli ,
B Godey  and
E Lescanne
B Pateron*
Affiliation:
Otorhinolaryngology and Head and Neck Surgery Department, University Hospital Center of Tours, France
D Bakhos
Affiliation:
Otorhinolaryngology and Head and Neck Surgery Department, University Hospital Center of Tours, France Joint Research Unit (French National Institute of Health and Medical Research – Unit 930, and French National Center for Scientific Research – Accredited Research Team 3106), François Rabelais University Hospital Center of Tours, France
A LeLouarn
Affiliation:
Medical Information, Epidemiology and Health Economy Department, University Hospital Center of Tours, France
P Bordure
Affiliation:
Otorhinolaryngology and Head and Neck Surgery Department, University Hospital Center of Nantes, France
A Bozorg Grayeli
Affiliation:
Otorhinolaryngology and Head and Neck Surgery Department, University Hospital Center of Dijon, France
B Godey
Affiliation:
Otorhinolaryngology and Head and Neck Surgery Department, University Hospital Center of Rennes, France
E Lescanne
Affiliation:
Otorhinolaryngology and Head and Neck Surgery Department, University Hospital Center of Tours, France Joint Research Unit (French National Institute of Health and Medical Research – Unit 930, and French National Center for Scientific Research – Accredited Research Team 3106), François Rabelais University Hospital Center of Tours, France
*
Address for correspondence: Dr Benedicte Pateron, Otorhinolaryngology and Head and Neck Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044 Tours, France E-mail: b.pateron@yahoo.fr
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Cochlear implantation is mostly performed under general anaesthesia. This study aimed to evaluate cochlear implantation performed under local anaesthesia and sedation.

Method:

Twenty patients had a cochlear implant fitted under combined local anaesthesia (local anaesthesia group) and 41 patients had one fitted under general anaesthesia (general anaesthesia group) for bilateral profound hearing loss, from 2011 to 2014. Surgical duration, period of post-operative hospitalisation and early post-operative symptoms were compared. In the local anaesthesia group, operative symptoms reported during the surgery and by questionnaire were analysed.

Results:

Mean surgical duration was significantly shorter in the local anaesthesia group: 87 versus 122 minutes (p < 0.001). No significant difference was observed between the local anaesthesia and general anaesthesia groups regarding mean post-operative hospitalisation and early post-operative symptoms. Under local anaesthesia, patients had no particular symptoms in 60 per cent of cases. The remaining patients in this group experienced vertigo (10 per cent), pain (20 per cent) and pain-related movement (10 per cent) during the intervention. These symptoms can be controlled with symptomatic treatment.

Conclusion:

Combined local anaesthesia for cochlear implantation is a good alternative to general anaesthesia for co-operating patients.

Keywords

Anesthesia, LocalCochlear ImplantationHearing LossConscious SedationAgedAdultComorbidities
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 2 , February 2016 , pp. 151 - 156
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Greenberg, MF, Pollard, ZF. Adult strabismus surgery under propofol sedation with local versus general anesthesia. J AAPOS 2003;7:116–20CrossRefGoogle ScholarPubMed
2GALA Trial Collaborative Group, Lewis, SC, Warlow, CP, Bodenham, AR, Colam, B, Rothwell, PM et al. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. Lancet 2008;372:2132–42Google Scholar
3Liang, S, Irwin, MG. Review of anesthesia for middle ear surgery. Anesthesiol Clin 2010;28:519–28CrossRefGoogle ScholarPubMed
4Vermeire, K, Brokx, JP, Wuyts, FL, Cochet, E, Hofkens, A, Van de Heyning, PH. Quality-of-life benefit from cochlear implantation in the elderly. Otol Neurotol 2005;26:188–95CrossRefGoogle ScholarPubMed
5Park, E, Shipp, DB, Chen, JM, Nedzelski, JM, Lin, VY. Postlingually deaf adults of all ages derive equal benefits from unilateral multichannel cochlear implant. J Am Acad Audiol 2011;22:637–43Google ScholarPubMed
6Shin, YJ, Fraysse, B, Deguine, O, Valès, O, Laborde, ML, Bouccara, D et al. Benefits of cochlear implantation in elderly patients. Otolaryngol Head Neck Surg 2000;122:602–6Google ScholarPubMed
7Eshraghi, AA, Rodriguez, M, Balkany, TJ, Telischi, FF, Angeli, S, Hodges, AV et al. Cochlear implant surgery in patients more than seventy-nine years old. Laryngoscope 2009;119:1180–3CrossRefGoogle ScholarPubMed
8Mosnier, I, Ambert-Dahan, E, Smadja, M, Ferrary, E, Bouccara, D, Bozorg-Grayeli, A et al. Performances and complications of cochlear implant in 134 adult patients implanted since 1990 [in French]. Ann Otolaryngol Chir Cervicofac 2006;123:71–8CrossRefGoogle ScholarPubMed
9Toner, JG, John, G, McNaboe, EJ. Cochlear implantation under local anaesthesia, the Belfast experience. J Laryngol Otol 1998;112:533–6CrossRefGoogle ScholarPubMed
10Toner, F, Jackson, CP, Toner, JG. How we do it: local anaesthetic cochlear implantation. Cochlear Implants Int 2013;14:232–5CrossRefGoogle Scholar
11Hamerschmidt, R, Moreira, AT, Wiemes, GR, Tenório, SB, Tâmbara, EM. Cochlear implant surgery with local anesthesia and sedation: comparison with general anesthesia. Otol Neurotol 2013;34:75–8CrossRefGoogle ScholarPubMed
12French National Authority for Health. Health technologies evaluation guidelines – Treatment of deafness by cochlear implantation or brain implantation stimulation [in French]. In: http://www.has-sante.fr/portail/upload/docs/application/pdf/rapport_implants_cochleaires.pdf [21 October 2015]Google Scholar
13Semaan, MT, Fredman, ET, Shah, JR, Fares, SA, Murray, GS, Megerian, CA. Surgical duration of cochlear implantation in an academic university-based practice. Am J Otolaryngol 2013;34:382–7CrossRefGoogle Scholar
14Majdani, O, Schuman, TA, Haynes, DS, Dietrich, MS, Leinung, M, Lenarz, T et al. Time of cochlear implant surgery in academic settings. Otolaryngol Head Neck Surg 2010;142:254–9CrossRefGoogle ScholarPubMed
15Prager, JD, Neidich, MJ, Perkins, JN, Meinzen-Derr, J, Greinwald, JH Jr.Minimal access and standard cochlear implantation: a comparative study. Int J Pediatr Otorhinolaryngol 2012;76:1102–6CrossRefGoogle ScholarPubMed
16Richard, C, Pascal, J, Martin, C. Local and regional anaesthesia in oto-rhino-laryngology [in Spanish]. EMC – Otorrinolaringología 2011;6:1–16Google Scholar
17Jourdy, DN, Kacker, A. Regional anesthesia for office-based procedures in otorhinolaryngology. Anesthesiol Clin 2010;28:457–68CrossRefGoogle ScholarPubMed
18Lescanne, E, Moriniere, S, Gohler, C, Manceau, A, Beutter, P, Robier, A. Retrospective case study of carbon dioxide laser stapedotomy with lens-based and mirror-based micromanipulators. J Laryngol Otol 2003;117:256–60CrossRefGoogle ScholarPubMed
19Bakhos, D, Lescanne, E, Charretier, C, Robier, A. A review of 89 revision stapes surgeries for otosclerosis. Eur Ann Otorhinolaryngol Head Neck Dis 2010;127:177–82CrossRefGoogle ScholarPubMed
20Alzahrani, M, Martin, F, Bobillier, C, Robier, A, Lescanne, E. Combined local anesthesia and monitored anesthesia care for cochlear implantation. Eur Ann Otorhinolaryngol Head Neck Dis 2014;131:261–2CrossRefGoogle ScholarPubMed
21Caner, G, Olgun, L, Gültekin, G, Aydar, L. Local anesthesia for middle ear surgery. Otolaryngol Head Neck Surg 2005;133:295–7CrossRefGoogle ScholarPubMed