228 Cases of Cochlear Implant Receiver‐Stimulator Placement in a Tight Subperiosteal Pocket without Fixation

Sweeney, Alex D.; Carlson, Matthew L.; Valenzuela, Carla V.; Wanna, George B.; Rivas, Alejandro; Bennett, Marc; Haynes, David S.

doi:10.1177/0194599814567111

Cited by 26 publications

(27 citation statements)

References 21 publications

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“…RS anchorage is performed to avoid any RS migration that might result in electrode displacement, implant extrusion and wire fatigue, resulting in device failure . Several methods of RS anchorage for the adult population have been proposed, including bony well drilling, tight subperiosteal pocket alignment, miniplate adaptation and sutures . Well drilling has been abandoned by some surgeons in favor of other alternative RS fixation techniques in an effort to reduce operative time.…”

Section: Discussionmentioning

confidence: 99%

Age‐dependent variations of scalp thickness in the area designated for a cochlear implant receiver stimulator

Ungar

Amit

Cavel

et al. 2018

Laryngoscope Investig Oto

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ObjectiveThe integrity of the scalp overlying a cochlear implant receiver stimulator (RS) is critical for the long‐term survival of the implant. Exposure or extrusion of the device will likely result in the need for its removal. There is a global trend of acceleration of population aging, thus raising the prevalence of cochlear implantation (CI) in the elderly. The aim of this study was to define age‐dependent changes in scalp thickness and discuss the implication of that anatomical characteristic for CI in the geriatric population.MethodsScalp thickness over the location of the RS in the temporo‐parietal area was measured directly with a needle in patients of various ages.ResultsTwo‐hundred thirty‐six temporo‐parietal scalps were measured in patients aged 18 to 85 years. A strong inverse correlation was found between age and scalp thickness (rs = ‐0.723, P < .001). Scalp thickness decreased with age from a mean of 8 mm in the third decade of life to 5 mm in the ninth decade of life.ConclusionThe human scalp thins with age and most likely undergoes a reduction in its strength. As a consequence, implantable hearing devices that are shielded by the scalp can be at increased risk of exposure and extrusion in the aging recipient. This needs to be taken into account when considering an implantation procedure, the surgical approach and patient instructions on need for and venues for continuing care over time.Level of Evidence2B

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Section: Discussionmentioning

confidence: 99%

Age‐dependent variations of scalp thickness in the area designated for a cochlear implant receiver stimulator

Ungar

Amit

Cavel

et al. 2018

Laryngoscope Investig Oto

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“…As the duration of surgery decreases, so does the exposure to anaesthesia and the cost of surgery. It was reported that surgery duration was significantly lower (up to 30 per cent) for the subperiosteal pocket technique in previous studies 12 , 15 . Although surgery duration was not analysed in the present study, it is known that drilling a bone implant bed and suture fixation prolongs surgery, but experienced surgeons can complete cochlear implant surgery in 30–40 minutes.…”

Section: Discussionmentioning

confidence: 56%

The effect of cochlear implant bed preparation and fixation technique on the revision cochlear implantation rate

Pamuk

Jafarov

et al. 2018

J. Laryngol. Otol.

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“…In our study, there was no intraoperative or intracranial complications observed in either groups, besides the device migration [4] [5].…”

Section: Discussionmentioning

confidence: 91%

“…In some cases, exposure of the dura is required and complications such as epidural hematoma, subdural hematoma, temporal lobe infarction and dural tears with cerebrospinal fluid leak can arise, although rare [4]- [6].…”

Section: Discussionmentioning

confidence: 99%

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Device Fixation in Cochlear Implant Surgery: Bone Well vs. Subperiosteal Muscle Pocket Technique

Lauria¹,

Truzzi²,

Guimarães³

et al. 2015

OALib

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Introduction: Cochlear implantation (CI) is a worldwide procedure that provides hearing rehabilitation and improves speech perception. One of the described complications is the device migration, which can result of failure of receiver-stimulator (R/S) fixation. This study aims to describe the outcomes of cochlear implant receiver-stimulator (RS) placement (bone well and the subperiosteral temporal pocket technique without fixation). Methods: A retrospective case review is developed in tertiary care university hospital center that compares the bone well and the subperiosteral temporal pocket technique without fixation in two periods (at the end of the surgery and one year after CI surgery). Results: The age range from 22 to 64 years (average of 41.2 year-old). Follow-up time ranges from 12 to 51 months (average 24 months). The patients, divided into two groups (subperiostal pocket = 6 patients and bone well = 3 patients), are analyzed through major and minor complications. No intraoperative wounds or intracranial complications have been observed in either group. Device migration occurs in three patients of subperiostal pocket group (50%), but with no apparent clinical outcomes. The migration measure is about not more than 1 up to 2 centimeters antero-inferiorly by the radiography evaluation. Conclusion: Device migration is more frequent in the subperioteal pocket group (50%) with statistical significance (p < 0.05). However it is not identified, apparently, no clinical and aesthetic account related to this situation.

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228 Cases of Cochlear Implant Receiver‐Stimulator Placement in a Tight Subperiosteal Pocket without Fixation

Abstract: The tight subperiosteal pocket without fixation is a safe, durable, and time-saving technique for RS placement during cochlear implantation. Notably, device migration and flap complications are very uncommon.

Cited by 26 publications

References 21 publications

Age‐dependent variations of scalp thickness in the area designated for a cochlear implant receiver stimulator

Age‐dependent variations of scalp thickness in the area designated for a cochlear implant receiver stimulator

The effect of cochlear implant bed preparation and fixation technique on the revision cochlear implantation rate

Device Fixation in Cochlear Implant Surgery: Bone Well vs. Subperiosteal Muscle Pocket Technique

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