(123) Day-case Otology : Special Attention to Pediatric Cochlear Implantation Procedure

Introduction: To evaluate the feasibility of cochlear implantation as day-surgery in children and to identify variables influencing admission, readmission and unplanned postoperative consultation.

Methods: Between January 2017 and July 2022, all medical records of children who underwent cochlear implantation were analyzed. Eligible children were admitted for the first time to the pediatric day-surgery (DS) unit. Exclusion criteria were children planned for inpatient procedure, bilateralization or explantation-reimplantation. In this retrospective observational monocentric study, sex, analgesic medication, anesthesia and complications were related to categorical variables. Age, duration of anesthesia, length of stay and ASA score were related to continuous variables.

Results: We included 66 children from a total of 106. Median age was 32 months [SD: 46 months, range 8-184 months]. Successful DS management was observed in 86%. In 14%, children were admitted to the pediatric ENT unit for the following reasons: late awakening in 6%, non-controlled pain in 4.5%, PONV in 3.5%. Univariate analysis did not observe any factor promoting success of DS regarding anesthetic agents. Administration of Propofol was not statistically significant (p=.706) nor was preventive analgesia with either paracetamol (p=.996), ibuprofen (p=.998), ketamine (p=.602) or morphine (p=1). Antiemetics had no influence on the success of DS (p=.998). Age < 1 year (n=10) or < 3 years (n=36) was not statistically significant as a factor of ambulatory failure (p=.132). Duration of stay and anesthesia were similar between children who were admitted and those who were not. Time spent in operating room was not a determining factor (p=.559). No children were rehospitalized. Early unplanned consultations were observed in 3% of cases for vertex edema in 1 case and uncomplicated otorrhea in 1 case.

Conclusions: This study completes the knowledge on pediatric cochlear implantation and suggests that procedure is suitable for day-surgery at any age, even in infants. The risk of failure is low and not influenced by anesthetic agents, duration of anesthesia and age.