After cochlear implantation: Complications related to flap around implants

Qin, Feifei; Li, Wen; Qiu, Jianxin; Zhang, Li; Mei, Zhong Lei

doi:10.1016/j.joto.2016.12.001

Cited by 15 publications

(13 citation statements)

References 14 publications

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“…However, the outcome of revision surgery was not guaranteed. After unsuccessful revision surgery, two patients (40%, 2/5) developed skin necrosis with implant exposure, similar to previous reports [ 1 , 6 ]. Conservative treatment with foreign body retention would have aggravated the patient’s condition.…”

Section: Discussionsupporting

confidence: 90%

“…[ 3 ] Qin et al reported 15 seromas around implants, all of which occurred within 1–2 years after CI surgery, while Low reported that hematoma episodes occurred 2–12 years (median, 6 years) after CI. [ 6 , 7 ] Table 2 shows the onset times for each patient in our study population; the times ranged from 2 months at the earliest to 10 years at the latest with a mean of 31.4 months. Therefore, rigorous follow-up for flap complications should be performed for a long time after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Management of delayed-onset skin flap complications after pediatric cochlear implantation

Chen

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose To review delayed-onset skin flap complications associated with pediatric cochlear implantation (CI) in our institute, analyze the etiology, and explore effective treatment strategies. Methods Retrospective analyses of 811 children who had undergone cochlear implantation between January 2003 and March 2019 were performed. Twelve (1.48%) patients developed skin flap complications after CI. We present a classification of flap issues and wound histopathology following cochlear implantation. The interventions for flap problems included drug treatment, aspiration, local wound care, revision surgery, and explantation depending on the clinical situation. The temporalis myofascial reconstructive option is discussed. Results Seven subjects were cured with conservative treatment. Five cases with flap infection or necrosis underwent revision surgery, with wound closure in three cases (60%) and revision surgery with explantation in the remaining two cases (40%). Explantation ultimately led to wound healing in all cases. They all achieved excellent performance through re-implantation. Conclusion Flap complications after CI are rare but treatable. Comprehensive treatments should be developed to achieve a stable and healed wound for CI.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Management of delayed-onset skin flap complications after pediatric cochlear implantation

Chen

et al. 2020

Eur Arch Otorhinolaryngol

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“…Vaccination with pneumococcal conjugate vaccine (PCV13) and Haemophilus influenzae type B (Hib) should be given prior to implantation, especially in cases of inner ear anomalies with the aim of reducing the incidence of meningitis. We had no cases of meningitis during the current study; however, as all the children had been vaccinated against Streptococcus pneumoniae as well as Haemophilus influenzae type B, and had been given perioperative injectable cefuroxime 25…”

Section: Discussionmentioning

confidence: 99%

Complications of post-cochlear implantation in 1027 adults and children

et al. 2019

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BACKGROUND The number of cochlear implant (CI) recipients is increasing so there needs to be greater awareness of possible CI complications. OBJECTIVES Describe complications of CI. DESIGN Retrospective, descriptional. SETTINGS Tertiary health care center. PATIENTS AND METHODS Data was collected by retrospective chart review on complications for recipients implanted for the period from January 2006 to June 2017. MAIN OUTCOME MEASURES Major and minor post cochlear implantation complications. SAMPLE SIZE 1027 cochlear implant recipients. RESULTS Post-operative complications were reported in 105 patients (10.2%). Minor complications were most often encountered (9.5%). Swelling (wound seroma or hematoma) was the most common complication. The major complication rate was only 7/105, 0.7%. Meningitis did not occur and cholesteatoma occurred in only one patient. CONCLUSION CI is a safe surgical procedure at our center. We believe that this is probably due to the preoperative protocol, the surgical technique used, and the postoperative care conducted for all our patients. Despite this, it is important that both physicians and patients have knowledge of the possible consequences and risks posed by CI, especially in view of the fact that these patients require lifetime follow-up. LIMITATIONS Further studies are needed, and should include more ENT centers across all regions of Saudi Arabia.

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“…Postoperative infection is one of the most common complications 5 , 7 , following cochlear implantation, and conservative treatments are suggested to be primary and first-line treatment. For post-CI infection, a routine procedure may sequentially involve antibiotic treatments, pus puncture, revision surgery and re-implantation 8 , which does not take into account the specific clinical postoperative manifestations of CI and may cause refractory SFI.…”

Section: Discussionmentioning

confidence: 99%

The biofilm characteristics and management of skin flap infection following cochlear implantation

Chen

Zeng

et al. 2022

Acta Otorhinolaryngol Ital

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SUMMARY Objective This study aims to assess the frequency, bacteriology, biofilm characteristics and management of skin flap infection (SFI) following cochlear implantation (CI). Methods The study enrolled 1,251 patients receiving CI in the First Affiliated Hospital of Fujian Medical University between August 2001 and March 2021. Scanning electron microscopy (SEM) was utilised to characterise the aetiology of infection. A proposed classification system was applied to optimise treatments for post-operative skin flap infection. Results After CI, SFI was reported in 16 patients (1.28%) and occurred more frequently in patients under 6 years of age. Of all SFI cases Staphylococcus aureus was the most common pathogen for flap infection, with 8 cases (50%) and bacterial biofilm was evident within the jelly-like substance on the surface of implanted devices in SFI patients. A two-stage classification was proposed to optimise the treatment schemes. Conservative therapy was recommended for stage I cases and surgical treatment for stage II patients. Conclusions Paediatric patients are more susceptible to SFI after CI, which may be attributed to the formation of bacterial biofilm. The proposed classification can facilitate the management of SFI.

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After cochlear implantation: Complications related to flap around implants

Cited by 15 publications

References 14 publications

Management of delayed-onset skin flap complications after pediatric cochlear implantation

Management of delayed-onset skin flap complications after pediatric cochlear implantation

Complications of post-cochlear implantation in 1027 adults and children

The biofilm characteristics and management of skin flap infection following cochlear implantation

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