Evaluation of a minimally invasive surgical fixation technique for young children with the Concerto Pin cochlear implant system

Abstract

In 2011, Med-El (Innsbruck, Austria) introduced a new cochlear implant system, designed to require a minimally invasive surgical technique and allow greater positional flexibility for its fixation on the skull. The Concerto Pin implant system is a good option for patients with thinner bone, such as children and elderly. The aim of this study was to investigate the implant’s stability in children using our minimally invasive surgical technique. This was a prospective, longitudinal study with a single-subject, repeated-examination design. Six children, implanted with a Concerto Pin using our minimally invasive surgical technique between October 2011 and September 2012, were assessed 1, 3 and 6 months after surgery. In each case, the implant remained in a stable position and no adverse events or problems with healing were observed at any time during the investigation. The minimally invasive technique and the method of implant fixation that bypass drilling a deep implant bed constitute a good option for patients with thinner bone, such as children. This clinical study shows the safety and stability of the Concerto Pin implant system using a minimally invasive surgical technique.

Electrode Migration in Patients with Perimodiolar Cochlear Implant Electrodes

“…Proper fixation of the receiver/ stimulator can be achieved by using different flap and subperiosteal pocket techniques [Adunka and Buchman, 2007;Cuda, 2013]. Additional screws and special tips at the receiver/stimulator have been established to avoid movement of the device [Davis et al, 2004;Lee and Driver, 2005;Schnabl et al, 2014]. Whether foreign bodies are really necessary to achieve proper fixation of the implant has been widely discussed in the literature [Adunka and Buchman, 2007;Boscolo-Rizzo et al, 2011;Molony et al, 2010].…”

Implant Stability in Adults and Children Implanted With Non-Pin or Pin Cochlear Implant Variants: Success With Different Surgical Techniques

“…This reflects the reduced thickness of the skull in children compared to adults, a fact which needs to be considered during implantation. Schnabl et al [14] showed that the pin variant is a good treatment option for subjects with thinner bone, such as children. Further evidence for this is provided in the present study, with the lowest rate of deviceor procedure-related adverse events seen in the pediatric subjects (Groups 2 and 4).…”

“…Sutureless fixation using a periosteal pocket or a temporalis muscle pocket with no drilling of a bony well have also been reported to be safe surgical techniques [10][11][12]. Minimally invasive surgery is less time-consuming and thus allows shorter total surgery time [9,13,14]. In turn, reduced surgery duration minimizes the impact of anesthesia on the subject, which is important when the elderly or very young children undergo surgery [15].…”

“…The pin variant, in particular, specifically aims for greater flexibility in positioning and fixing the implant on the skull, with the pins ensuring stability. Additionally, less (or no) drilling and no tie-down sutures are required [14].…”