Subtotal petrosectomy and cochlear implantation: Revision surgery

Abstract Purpose To review delayed-onset skin flap complications associated with pediatric cochlear implantation (CI) in our institute, analyze the etiology, and explore effective treatment strategies. Methods Retrospective analyses of 811 children who had undergone cochlear implantation between January 2003 and March 2019 were performed. Twelve (1.48%) patients developed skin flap complications after CI. We present a classification of flap issues and wound histopathology following cochlear implantation. The interventions for flap problems included drug treatment, aspiration, local wound care, revision surgery, and explantation depending on the clinical situation. The temporalis myofascial reconstructive option is discussed. Results Seven subjects were cured with conservative treatment. Five cases with flap infection or necrosis underwent revision surgery, with wound closure in three cases (60%) and revision surgery with explantation in the remaining two cases (40%). Explantation ultimately led to wound healing in all cases. They all achieved excellent performance through re-implantation. Conclusion Flap complications after CI are rare but treatable. Comprehensive treatments should be developed to achieve a stable and healed wound for CI.

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Subtotal Petrosectomy for cochlear implantation in cases of Chronic Otitis Media

The Journal of Laryngology & Otology ◽

10.1017/s0022215116002036 ◽

2016 ◽

Vol 130 (S3) ◽

pp. S27-S27

Author(s):

Miguel Arístegui

Keyword(s):

Otitis Media ◽

Cochlear Implantation ◽

Chronic Otitis Media ◽

Subtotal Petrosectomy

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Audiological outcome of stapes surgery for far advanced cochlear otosclerosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215117001815 ◽

2017 ◽

Vol 131 (11) ◽

pp. 961-964 ◽

Cited By ~ 2

Author(s):

C Heining ◽

R Banga ◽

R Irving ◽

C Coulson ◽

P Monksfield

Keyword(s):

Hearing Loss ◽

Cochlear Implant ◽

Revision Surgery ◽

Cochlear Implantation ◽

Stapes Surgery ◽

Hearing Thresholds ◽

Suitable Treatment ◽

Conductive Component ◽

Clinically Significant ◽

Hearing Outcomes

AbstractBackground:Patients with advanced otosclerosis can present with hearing thresholds eligible for cochlear implantation. This study sought to address whether stapes surgery in this patient group provides a clinically significant audiological benefit.Objectives:To assess pre- and post-operative hearing outcomes of patients with advanced otosclerosis, and to determine what proportion of these patients required further surgery including cochlear implantation.Methods:Between 2002 and 2015, 252 patients underwent primary stapes surgery at our institution. Twenty-eight ears in 25 patients were deemed to have advanced otosclerosis, as defined by pure audiometry thresholds over 80 dB. The patients’ records were analysed to determine audiological improvement following stapes surgery, and assess whether any further surgery was required.Results:The audiological outcome for most patients who underwent primary stapes surgery was good. A minority of patients (7 per cent) required revision surgery. Patients who underwent cochlear implantation after stapes surgery (10 per cent) also demonstrated a good audiological outcome.Conclusion:Stapes surgery is a suitable treatment option for patients with advanced otosclerosis, and should be considered mandatory, before offering cochlear implantation, for those with a demonstrable conductive component to their hearing loss. A small group of patients get little benefit from surgery and subsequently a cochlear implant should be considered.

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