Management of late extrusions of cochlear implants.
| Autor: | Parkins CW; Louisiana State University Medical Center, Department of Otolaryngology--Head and Neck Surgery, New Orleans 70112, USA., Metzinger SE, Marks HW, Lyons GD |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | The American journal of otology [Am J Otol] 1998 Nov; Vol. 19 (6), pp. 768-73. |
| Abstrakt: | Objectives: The study aimed to identify the important principles in repairing and preventing delayed cochlear implant extrusions. Study Design: The study design was a retrospective, international database review and three case presentations from the authors' local database. Setting: The study was conducted at a tertiary referral center. Patients: Cochlear Corporation's database of 8,665 implantees in North and South America and Israel was studied. A subset of this database, consisting of 74 patients implanted through the Louisiana State University/Eye, Ear, Nose and Throat (LSU/EENT) project, is analyzed separately and provides the case reports. Intervention: Surgical repair of skin breakdown over the edge of three cochlear implants using a two-layer, pericranial and scalp rotation flap technique was performed. Main Outcome Measures: A functioning cochlear implant with a healthy skin covering was measured. Results: The three LSU/EENT cases reported here used a pericranial flap to repair the capsule of the implant and a large scalp rotation flap to repair the skin defect. A novel pericranial tuck-under technique is especially useful for the Nucleus Mini-22 implant. With this technique, the authors have had a 100% success rate (3 of 3). The basic principles used in the repair and in the initial implant surgery are discussed. Conclusions: The following conclusions were reached: 1) avoid skin closure lines parallel to the cochlear implant edge that are closer than 1.5 cm from the implant edge; 2) excise enough skin and scar around the dehiscence to achieve principle 1; 3) design a large, well-vascularized anterior- or posterior-based scalp rotation flap to cover this defect; and 4) close the implant capsule defect with a well-vascularized pericranial flap. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|