Management of cochlear implant device extrusion: case series and literature review

Abstract

Surgeons should be aware of the reconstructive options available in such circumstances, and should choose appropriate management depending on the clinical situation, in order to optimise the functional result for the patient.

Microvascular free tissue transfer and cochlear implants: A case series and literature review

“…The authors report audiometric data, speech perception measured by CNC word score improved from 2% to 56% 3 months postoperatively. Geraghty et al describe an additional patient with cochlear implant site infection and necrosis who failed a scalp rotation flap . At the time of subsequent explantation, pericranial bacterial biofilms were noted, and the defect was closed with an ALT free, although the author do not specify if the patient was reimplanted after recovery from this operation.…”

“…Cochlear implantation (CI) for patients with severe to profound sensorineural hearing loss is an effective and safe procedure . Nonetheless, complications including skin flap necrosis, wound dehiscence, infection, and cochlear implant extrusion occur at a rate of approximately 2% to 8% . To avoid these complications, the CI surgical site requires well‐vascularized, healthy tissue to reconstruct and protect the cochlear implant and surrounding structures.…”

“…Approaches to cochlear device extrusion including microvascular free tissue transfer (MVFTT) reconstruction are infrequently reported, presumably due to their complexity, increased invasiveness, length of postoperative recovery period, and need for referral to a surgeon trained in microvascular head and neck reconstruction . However, the safety and role of MVFTT in the reconstruction of lateral temporal bone and scalp defects after temporal bone surgery for tumor resection, chronic infection, or osteoradionecrosis is well established .…”

Reconstruction of a scalp defect due to cochlear implant device extrusion using a temporoparietal fascia flap and a split-thickness skin graft from the scalp

“…Cochlear implants are a safe and effective treatment for severe sensorineural hearing loss. Common non-device related complications include skin flap necrosis, infection, dehiscence, and device extrusion in 1.7% to 10% of cases [1,5]. Migration of skin tension and the device caused by the bulk of the receiver can lead to flap erosion as a possible cause of implant extrusion.…”

“…Migration of skin tension and the device caused by the bulk of the receiver can lead to flap erosion as a possible cause of implant extrusion. Additional causes of implant extrusion include consistent external pressure on the implant site, old age, use of steroids, radiotherapy, anticancer therapy, and smoking [5,6]. According to previous studies, using an anteriorly-based C-shaped flap for cochlear implantation can block the blood supply from the occipital artery, causing flap-related complications.…”