The feasibility of day case cochlear implant surgery.

Aim: Day case surgery was originally described as far back as 1909. Even then, the now accepted advantages were recognized, including reduced hospital infection rates, financial benefits and reduced pressure on hospital beds. Cochlear implant (CI) surgery has traditionally required inpatient stay in hospital. The aim of this study is to determine the viability of day case cochlear implant surgery in our unit and to develop strategies to increase the rates of same day discharge if possible. Methods: A retrospective review was carried out of all adult and paediatric patients who underwent cochlear implantation in a single centre (Guy's and St Thomas' Hospital) between January 2014-October 2017. Patients were obtained from a prospectively created departmental database and data captured from the medical notes. Every patient had a post-operative follow-up between 7-10 days after surgery and clinical progress was formally recorded subsequently. Results : During the study period 511 CI were performed. This included 334 paediatric CI (193 patients) and 177 adult CI (41 patients). The total number of complications was 14 (3.7%), including local wound infections (9 patients), wound dehiscence (2 patients) and vertigo/dizziness/nausea requiring an extended stay (3 patients). 11 (5.7%) paediatric and 15 (8.4%) adult patients were discharged on the same day of surgery (7% of total). Only one patient (3.8%) experienced a complication (a minor wound infection). Conclusion: Day case CI surgery appears to be safe practice. We did not encounter any complications within the first 72 hours in those patients discharged on the same day of surgery. We aim to increase our day case CI surgery rates, whilst acknowledging that it may not possible in all cases. We have implemented changes in the department to increase the number of day case patients who are suitable for CI surgery. We are also prospectively collecting patient satisfaction questionnaires. [ABSTRACT FROM AUTHOR]