Diagnosing complications following cochlear implantation using transcutaneous ultrasound

Rupp, Robin; Thimsen, Vivian; Balk, Matthias; Mueller, Sonja; Sievert, Matti; Mantsopoulos, Konstantinos; Hoppe, Ulrich; Hornung, Joachim; Iro, Heinrich; Gostian, Antoniu‐Oreste

doi:10.1007/s00405-021-07128-2

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…In cases where the extent or location of collection is uncertain, ultrasound examination can provide valuable information in addition to that available from clinical examination and can also be helpful in distinguishing other causes of swelling, e.g. pneumocele around the package (11). Differentiating between seroma and hematoma may still be challenging.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Swelling in Pediatric Cochlear Implant Patients

Shaida

Magos²,

Kanona³

et al. 2023

Otol Neurotol

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ObjectiveTo determine the prevalence, characteristics, and outcomes of pediatric patients with recurrent swelling over their cochlear implant receiver package.Study DesignRetrospective case review.SettingTertiary referral center.PatientsA total of 332 bilateral cochlear implant patients under the age of 18 years were reviewed. Twelve patients with more than one episode of swelling around their cochlear implant receiver package were isolated. Patients with clinical evidence of infection were excluded from the study. The etiology of hearing loss was heterogeneous.InterventionThree patients underwent ultrasound, and three patients underwent bedside aspiration. Most patients were treated with 7 days of oral broad-spectrum antibiotics.Main Outcome MeasureIncidence, frequency, and course of recurrent swelling around cochlear implant receiver packages.ResultsThe first swelling appeared between 0.86 and 9.95 years after surgery (mean, 3.38), and the occurrence of the last episode ranged from 0.06 to 3.42 years from the current date (mean, 1.04). The total number of episodes ranged from 2 to 18 (mean, 6). Seven patients had unilateral swellings, and five had bilateral swellings. Swellings were associated with upper respiratory tract infection or minor trauma, or had no identifiable cause. Aspiration in three cases showed evidence of altered blood.ConclusionsRecurrent otherwise asymptomatic swelling over cochlear implant receiver packages in children is more common than initially thought. Possible causes include hematoma and seroma secondary to upper respiratory tract infection. The incidence and the timing of swelling are variable. There were no swelling-related device failures or reimplantations so patients and parents can be reassured about the long-term outcome.

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Section: Discussionmentioning

confidence: 99%

Recurrent Swelling in Pediatric Cochlear Implant Patients

Shaida

Magos²,

Kanona³

et al. 2023

Otol Neurotol

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Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma

Sievert

Aubreville

Gostian

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose Confocal laser endomicroscopy (CLE) allows imaging of the laryngeal mucosa in a thousand-fold magnification. This study analyzes differences in tissue homogeneity between healthy mucosa and squamous cell carcinoma (SCC) via CLE. Materials and methods We included five SCC patients with planned total laryngectomy in this study between October 2020 and February 2021. We captured CLE scans of the tumor and healthy mucosa. Analysis of image homogeneity to diagnose SCC was performed by measuring the signal intensity in four regions of interest (ROI) in each frame in a total of 60 sequences. Each sequence was assigned to the corresponding histological pattern, derived from hematoxylin and eosin staining. In addition, we recorded the subjective evaluation of seven investigators regarding tissue homogeneity. Results Out of 3600 images, 1620 (45%) correlated with benign mucosa and 1980 (55%) with SCC. ROIs of benign mucosa and SCC had a mean and standard deviation (SD) of signal intensity of, respectively, 232.1 ± 3.34 and 467.3 ± 9.72 (P < 0.001). The mean SD between the four different ROIs was 39.1 ± 1.03 for benign and 101.5 ± 2.6 for SCC frames (P < 0.001). In addition, homogeneity yielded a sensitivity and specificity of 81.8% and 86.2%, respectively, regarding the investigator-dependent analysis. Conclusions SCC shows a significant tissue inhomogeneity in comparison to the healthy epithelium. The results support this feature’s importance in identifying malignant mucosa areas during CLE examination. However, the examiner-dependent evaluation emphasizes that homogeneity is a sub-criterion that must be considered in a broad context.

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Diagnosing complications following cochlear implantation using transcutaneous ultrasound

Cited by 2 publications

References 26 publications

Recurrent Swelling in Pediatric Cochlear Implant Patients

Recurrent Swelling in Pediatric Cochlear Implant Patients

Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma

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