Surgical considerations in cochlear implantation in children and adults: A review of 342 cases in Vienna

Abstract

The etiology of deafness was predominantly congenital or progressive (66.89%). The routine mastoidectomy approach was chosen in 300 patients (87.72%) and the suprameatal approach in 42 (12.28%). Intraoperatively, 4 children (2.53%) had a cerebrospinal fluid fistula and 35 patients (10.23%) showed cochlear ossification. Three adults (1.63%) and two children (1.27%) had facial nerves with an aberrant course. The overall complication rate was 12.2%, the rate of major complications was 4.97% and the rate of minor complications was 4.09%. There were no cases of either postoperative meningitis or facial nerve palsy. Both flap necrosis and electrode dislocation occurred in one adult patient (0.54%), but in none of the children. Formation of cholesteatoma was found in one adult (0.54%) and one child (0.63%). The rate of device failure was 7.07% for adults and 13.92% for children.

Periorbital Ecchymosis: An Uncommon Complication of Cochlear Implantation

“…Minor complications include dehiscence of incisions, infection, facial nerve stimulation, dizziness, and pedestal problems with the device [2]. Flap necrosis or wound dehiscence, is the most common complications with an incidence of 4.5 to 11.2%, major complications are those requiring further surgery or hospitalization, occur at rates 2.1 to 11.7% whereas minor complications are those which can be treated with medical management, have a slightly higher incidence, 5.8 to 25.4% [3,5]. Even if the complications are rare they should be carefully assessed.…”

“…After the entire required test showed no any surgical contraindication. Patient performed right ear cochlear implantation via facial recess approach [1][2][3][4][5][6][7][8][9][10]. Intraoperative ART and NRT showed values with in normal range C-arm X-ray imaging showed electrode arrays implanted with in cochlea (Figure 2).…”

Responsibilities of Nurse in Cochlear Implant Surgery: Review

“…17,20,21 Elektrodu olan bir implant çeşidi kullanılıyorsa temporal kas altında açılan subperiostal cebe yerleştirilir. 6,20,22 Bundan sonra önemli nokta, elektrodun skala timpani içerisinde, baziller membran ve spiral ligamanı travmatize etmeksizin tümüyle içe-riye gönderilmesidir. 17,20 Daha sonra kokleostomi ile elektrot arasındaki açıklık perikondrium ile kapatılır.…”

Modification of classic reconstructive techniques and evaluation of new esthetic methods in terms of the expectations of modern oto-rhino-laryngology and head-neck surgery

“…Choosing the appropriate surgical method in case of larger defects is sometimes difficult. One option is to relocate the implant to a "safer" location in the surrounding of the original operation site, however this is technically difficult and results is new scars and areas of alopecia (55)(56)(57)(58). Local rotation flaps, which also produce scars, are the most reasonable choice, if the skin incision line avoids the implant location.…”

“…Local rotation flaps, which also produce scars, are the most reasonable choice, if the skin incision line avoids the implant location. Occipital flaps have the best vascularization and their other advantage is their proximity to the defect and that the scar lines can be easily disguised by a longer hair style (55,56,58,59). A special entity is the Superficial Temporal Fascia Flap, which receives its blood supply from the fascia of the temporal muscle, so a well vascularized layer is placed between the skin and the implant.…”