Haematoma after cochlear implantation: Management of a minor complication

Abstract

Patients were divided into four groups on the basis of the main predisposing factor: coagulation disorders (n=7), trauma (n=3), revision surgery (n=6) and haematoma of unknown origin (n=6). The main factors correlated to haematoma onset were coagulation disorder, type of skin incision and flap revision. In all, 21 subjects had complete recovery and the speech perception performance was not compromised over time, while 1 subject (0.3%) with an extensive haematoma due to a pharmacologically induced coagulation disorder required explantation of the device.

A Case Report of Delayed Onset Spontaneous Hematoma, Pain, and Temporal Bone Neo-Ossification 16 Years After Cochlear Implantation

“…3 Current treatment strategies suggest conservative hematoma evacuation through needle aspiration and additional diagnostic procedures to account for underlying etiological factors such as infection, coagulopathies, or repeated head trauma. [3][4][5] Pain has been reported as an isolated delayed-onset complication and regarded as a possible early symptom of cochlear implant malfunction. Some authors also suggest that delayed-onset pain should be considered a major complication since a significant amount of these patients require revision surgery.…”

Delayed-onset haematoma formation after cochlear implantation

“…A Medline search revealed only one paper that dealt specifically with such a complication. In a retrospective study on 22 subjects with post-cochlear implant haematoma, 4 subjects presented with delayed-onset lesions years after the cochlear implant surgery 2 . Each of them had a distinct preceding cause: three had a definite history of trauma to the implant site and one had coagulation disorder.…”

“…Quoted to have an incidence of 0.4–3.7 per cent, the vast majority of haematomas occur in the immediate and early post-implant period 2 . We present and discuss a series of patients who developed haematoma several months or even years after the initial cochlear implant surgery.…”

“…Post-implant haematoma is considered a minor complication, but can have serious consequences if not properly managed. For example, mismanagement could result in an infected haematoma, with the risk of total implant extrusion 2 …”

Skin Flap Necrosis by Bone Marking with Methylene Blue in Cochlear Implantation

“…Hematomas occur in the presence of coagulation disorders and inappropriate hemostasis. While this complication can be treated by re-intervention or aspiration, it may evolve into flap necrosis [ 6 ]. The technique for skin incision is a possible predisposing factor of flap necrosis.…”