7 Complications and Revision Surgery in Cochlear Implantation

Author(s):  
Giovanni Pepe ◽  
Sebastiano Franzini ◽  
Maurizio Guida ◽  
Maurizio Falcioni

Author(s):  
Qingling Bi ◽  
Zhongyan Chen ◽  
Yong Lv ◽  
Jie Luo ◽  
Naya Wang ◽  
...  

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.


2017 ◽  
Vol 131 (11) ◽  
pp. 961-964 ◽  
Author(s):  
C Heining ◽  
R Banga ◽  
R Irving ◽  
C Coulson ◽  
P Monksfield

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.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eleanor Layfield ◽  
Tiffany Peng Hwa ◽  
James Naples ◽  
Ivy Maina ◽  
Jason A. Brant ◽  
...  

2015 ◽  
Vol 129 (9) ◽  
pp. 916-918 ◽  
Author(s):  
K S Orhan ◽  
B Polat ◽  
N Enver ◽  
Y Güldiken

AbstractBackground:In recent years, the subperiosteal pocket technique has become popular for minimal access cochlear implantation. Many incision techniques have been described in cochlear implantation.Objective:This study aimed to demonstrate the safety and reliability of a new periosteal incision, called tailed Palva incision, in cochlear implantation.Methods:A total of 280 patients who underwent cochlear implantation with the subperiosteal pocket technique between June 2008 and January 2013 were included in the study.Results:The patients were followed up for between 11 and 74 months (mean ± standard deviation = 34 ± 19 months). No intracranial complications were seen during or after the operations. Additionally, there was no migration of the receiver-stimulator. Revision surgery was performed in eight patients (3 per cent), one of whom (0.4 per cent) had local flap failure and infection.Conclusion:This study shows that the tailed Palva incision facilitates easy insertion of the implant and, by creating a one-way obscured pocket, this technique also enhances stabilisation of the receiver-stimulator, thereby avoiding anterior migration.


2020 ◽  
Vol 146 (5) ◽  
pp. 414
Author(s):  
So Yeon Kim ◽  
Min Bum Kim ◽  
Won-ho Chung ◽  
Yang-Sun Cho ◽  
Sung Hwa Hong ◽  
...  

2017 ◽  
Vol 12 (3) ◽  
pp. 167-170
Author(s):  
Adina Zamfir-CHIRU-ANTON ◽  
◽  
Dan Cristian GHEORGHE ◽  
◽  

Vestibular syndrome after cochlear implantation is described in the literature. Its causes are variate but not always amenable to etiologic approach. We describe a patient wich developed cochlear electrode extrusion with persistent vestibular symptoms after a succesful insertion. Material and method. Photos from surgery and CT imaging were used to show this postoperative complication. Results. Revision surgery was necessary to reinsert and properly imobilise the electrode to the osseous walls of the mastoidectomy cavity. Symptoms disappeared completely after this procedure. Conclusions. Persistent vestibular symptoms after cochlear surgery require special and continuous monitoring. Revision surgery is indicated wherever imaging investigations suggest possible and corectable causes.


2016 ◽  
Vol 27 (10) ◽  
pp. 846-850 ◽  
Author(s):  
Habib G. Rizk ◽  
Francesca Hagood ◽  
Meredith A. Holcomb ◽  
Ted A. Meyer

Background: Patients with cochlear malformations were long considered poor candidates for cochlear implantation (CI), and surgical approaches different than the standard facial recess approach were used to access the inner ear. There is no previous long-term follow-up of a patient with significantly malformed inner ear operated through an untraditional route and requiring a revision surgery. Purpose: This case provides a long-term follow-up from the initial surgery, a short-term follow-up from the revision surgery, and it illustrates the evolving classification of inner ear malformations as well as the potential problems associated with nonstandard approaches to the cochlea. Research Design: A case report. Intervention: Herein, we report a case of revision CI in a patient with incomplete partition type I, through the round window via a facial recess approach, 18 yr after an initial implantation via a transmastoid labyrinthotomy approach. Results: The patient had an uncomplicated surgery, and after activation, she noted auditory perception on all electrodes without facial stimulation. A sound field sound awareness threshold was obtained at 15 dB HL. Conclusions: As the prior generation of cochlear implant recipients ages, the probability of a revision surgery for various causes increases. Cochlear implant surgeons should be aware of the potential pitfalls associated in these often challenging cases.


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