{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:18:28Z","timestamp":1792019908876,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>As the population ages and implantation criteria are relaxed, more patients with complex comorbidities are becoming eligible for cochlear implantation (CI). These patients have higher risks associated with general anesthesia. This systematic review assesses outcomes and complications following CI under local anesthetic to examine utility for patients deemed not suitable or at high risk for general anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review and meta\u2010analysis performed according to the 2020 PRISMA guidelines. Databases searched were MEDLINE, PubMed, EMBASE, CINAHL, Web of Science Core Collection, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials and<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>. There were no limitations on year of publication or language.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Then, 132 unique were identified. After screening abstracts and full texts for eligibility criteria a total of 18 articles were included. In the nine studies where audiological data were reported, all patients demonstrated improvement in audiological outcomes following implantation under local anesthetic (LA). Only minor complications of transient vertigo, wound infection, facial nerve paralysis, confusion, and tinnitus were reported but all were transient. Meta\u2010analysis showed surgical time was significantly shorter under LA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CI under LA is safe for patients with comorbidities which preclude them from general anesthesia, with minimal complications and an improved cost\u2010effectiveness profile. However, larger scale, robust trials are required to assess this further.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.720","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T09:48:39Z","timestamp":1641376119000},"page":"226-236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Cochlear implantation under local anesthetic: A systematic review and<scp>meta\u2010analysis<\/scp>"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5208-6446","authenticated-orcid":false,"given":"Ben","family":"Walters","sequence":"first","affiliation":[{"name":"Royal Stoke University Hospital Stoke On Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-5569","authenticated-orcid":false,"given":"Peter","family":"Gaskell","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3065-0269","authenticated-orcid":false,"given":"Jameel","family":"Muzaffar","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham Birmingham UK"},{"name":"Department of Clinical Neurosciences University of Cambridge, Addenbrooke's Health Campus Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3266-4015","authenticated-orcid":false,"given":"Haissan","family":"Iftikhar","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7343-7105","authenticated-orcid":false,"given":"Peter","family":"Monksfield","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8050-3617","authenticated-orcid":false,"given":"Manohar","family":"Bance","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences University of Cambridge, Addenbrooke's Health Campus Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organisation.Deafness and hearing loss [Internet].2021.https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/deafness-and-hearing-loss."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e31826b145a"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2020.07.008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc13084"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30367-6"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.65"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200405000-00017"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11243"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep310"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318278c1b2"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01626-4"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta19900"},{"key":"e_1_2_6_14_1","unstructured":"OCEBM Levels of Evidence Working Group.HowickJ ChalmersI GlasziouP et al.Levels of evidence\u2014Centre for Evidence\u2010Based Medicine (CEBM). 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