Five patients presented with infection and an exposed cochlear implant and we decided to salvage them by attempting use of new antimicrobial treatment for biofilms using betaine surfactant and polyhexanide along with wound debridement and double layered vascularized flap. This is the first study demonstrating the use of betaine surfactant and polyhexanide in the management of biofilm in cochlear implants and we could salvage four infected cochlear implants by the aforementioned method. Early intervention can significantly improve salvage outcomes in cochlear implants infected with biofilms.
Introduction The aim of our study is to compare the surgical complications of the transcanal and posterior tympanotomy approach and to evaluate the advantages and disadvantages of both techniques.
Materials and Methods It is a prospective study involving 252 pediatric cochlear implant patients operated in the Department of ENT, GMERS Medical College and General Hospital, Gandhinagar, Gujarat, India. Out of these, 126 patients were operated by transcanal approach (group A) and 126 patients were operated by posterior tympanotomy approach (group B).
Results No significant difference in the mean duration of surgery (p > 0.064) was observed in both the groups. Major complications occurred in 60.2% of group A and 3.1% of group B and minor complications occurred in 65% of group A and 3.1% in group B, which is highly significant (p < 0.0134). The categories of auditory perception, speech intelligibility rating scales, meaningful auditory integration scale, and meaningful use of speech scale were assessed in both groups.
Conclusion Complication rate in the transcanal approach is higher as compared with posterior tympanotomy approach. A complete alignment and introduction of electrode array into the basal turn of cochlea is more favorable in the posterior tympanotomy approach. Transcanal technique even as an alternative may not be useful. Outcomes may be affected depending upon the technique chosen.
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