The management of cochlear implant exposure can be very challenging especially in the pediatric population where reconstructive options are limited. Various techniques comprising conservative and surgical methods have been used to prevent explanation with variable success rates. We describe the use of the temporoparietal fascial flap (TPFF) for this purpose due to its wide coverage and tension-free closure. We present the case of a child who had implant exposure 3 months after the surgery. He was managed conservatively initially. When this failed restoring of the wound was done. However, this also was not successful. Then we tried coverage with TPFF and split-thickness skin grafting of the TPFF donor site which succeeded. Our experience provides evidence that TPFF can be used for the coverage of post aural wound in cases of implant exposure and when combined with a splitthickness skin graft (STSG) of the donor site, it can further increase the success rates. The STSG of the donor site ensures a tensionfree closure in comparison with primary closure which would put further pressure on the TPFF.
Introduction
Ectopic thyroid is a rare congenital condition. Dual ectopic thyroid is rarer still with only 30 cases reported in literature. The most common location is the lingual or sublingual region followed by the hyoid region. Instances of dual ectopic thyroid with one in lingual region and the other in mediastinum are very few.
Case Report
A case of dual ectopic thyroid is presented with absent normal thyroid in a girl of 14 years who presented with difficulty in swallowing and lump sensation in throat. Ultrasound, MRI scan and Technetium 99m pertechnetate thyroid scan were done. She showed lingual thyroid and thyroid tissue in upper mediastinum and no thyroid tissue in the normal anatomical location.
Discussion
The discovery of mediastinal ectopic thyroid was incidental. She had subclinical hypothyroidism and was treated with thyroxine replacement therapy.
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