ArticleBMC surgery2025
CSF gushers in cochlear implantation: surgical planning and management.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCochlear implants (CIs) have made it possible to significantly improve hearing in people with profound hearing loss. Although, cochlear implants are considered a safe procedure, this minimally invasive surgery has an overall complication rate of 12.5%. With Gusher (cerebrospinal fluid outflow) considered a common intraoperative complication of cochlear implants.
methodsIn this retrospective study, clinical files of patients with severe to profound sensorineural hearing loss who had undergone cochlear implantation were retrospectively reviewed. We calculated the incidence and risk factors of gusher and management options used . Statistical analysis included non-parametric tests and multivariate ordinal logistic regression to explore predictors of CSF leak intensity.
results1050 patients with profound hearing loss who underwent CI, 21 of whom had an intraoperative cerebrospinal fluid (CSF) leak, i.e. 2%, with a mean age of 3.5 years, and a sex ratio of 0.62, i.e. 62% female and 38% male. 43% of patients with gusher had structural abnormalities on their CT scan. Dilatation of the vestibule and vestibular aqueduct, as well as Mondini dysplasia, were the most common anomalies in Gusher patients. Younger implantation age was the only factor associated with higher CSF leak intensity in univariate analysis, but no independent predictors were identified in multivariate analysis.
conclusionsAdvancements in surgical techniques, radiological assessments, and technological innovation have significantly reduced cochlear implant–related complications, leading to a decreased risk of cerebrospinal fluid leakage incidents.
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