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Skin flap complications after cochlear implantations.
- Source :
-
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2016 Dec; Vol. 273 (12), pp. 4175-4183. Date of Electronic Publication: 2016 May 31. - Publication Year :
- 2016
-
Abstract
- The objective of the study was to analyse and present the surgical management strategy for major skin flap complications (MSFC) after cochlear implantations. Patients fitted with a titanium-silicone-coated implant of the same kind, operated on between 1994 and 2013 with a standardised procedure (1076 medical charts) were analysed. Analysis aimed to identify and study individuals with skin problems related to the cochlear implant treatment, i.e. requiring surgical treatment in hospital defined as MSFC and focused on incidence, risk factors and treatment of MSFC. MSFC were diagnosed in 1.76 % of patients: 2.06 % of children and 1.35 % of adults, 2.43 % after implantation with a long "C"-shaped incision and 1.28 % after short retroauricular incision. Registered risk factors included head trauma, acute otitis media, poor hygiene in children, and general comorbidities in adults. The primary intervention was dependent on skin complication severity and included revision surgery with wound closure over an implant (52.6 %) and revision surgery with explantation (47.4 %). Revision surgery without explantation was successful in 40 % and the most effective approach was debridement with a two-layer rotational flap. Explantation led to ultimate wound healing in all cases. Major skin flap complications after cochlear implantation are rare, but their treatment is complex and difficult. Revision surgery with resection of infected tissue, formation of a rotational two-layer flap preceded and supplemented by intensive targeted antibiotic therapy can be effective and should be the first treatment option. Spontaneous implant explantation, abscess formation or unsuccessful primary treatment necessitate implant removal as the ultimate solution.<br />Competing Interests: The authors declare that they have no conflict of interest. Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents therapeutic use
Child
Child, Preschool
Cochlear Implants
Comorbidity
Craniocerebral Trauma epidemiology
Debridement
Female
Humans
Hygiene
Infant
Male
Middle Aged
Otitis Media epidemiology
Poland epidemiology
Postoperative Complications
Reoperation
Retrospective Studies
Risk Factors
Young Adult
Cochlear Implantation
Surgical Flaps adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1434-4726
- Volume :
- 273
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 27245752
- Full Text :
- https://doi.org/10.1007/s00405-016-4107-1