Evaluation of Skin Scars Following Cochlear Implant Surgery

Abstract

OBJECTIVE:The understanding of speech is the most important outcome parameter after cochlear implantation. However, due to the excellent functional results of cochlear implantation in most patients, there is recently also a growing focus on patient comfort issues, e.g., aesthetic results. MATERIALS and METHODS:This study evaluated 34 skin scars after cochlear implant surgery in adults using the Stony Brook Scar Evaluation Scale, a well-validated instrument with a high interrater reliability and construct validity for evaluating the aesthetic outcome of skin scars. RESULTS:The mean follow-up time was 62 months. Using a retroauricular incision, the scars had an excellent to good aesthetic appearance in 85% of the cases. Revision surgery was the main factor for aesthetically unsatisfactory scars. CONCLUSION:The aesthetic outcome of skin scars after cochlear implant surgery is excellent or good for the majority of the patients. The most important risk factor for an unsatisfactory aesthetic outcome is revision surgery, an issue that should be communicated in preoperative counselling.

Patient Satisfaction with Postaural Incision Site

“…Postaural incisions are well established in middle ear surgery and are used as an approach to combined approach tympanoplasty and cortical mastoidectomy. Due to the cosmetic advantage from their concealed position and direct access to the mastoid air cells, they also play an increasing role in cochlear implant surgery [ 1 , 2 ]. They are also used in other fields of head and neck surgery, including resection of benign parotid gland tumours [ 3 ] and robotic-assisted neck dissection [ 4 ].…”

“…Cosmetic outcomes have also been investigated. Retroauricular skin scars had an excellent aesthetic outcome in cochlear implant surgery [ 2 ]; and in a small follow up study, Hong et al [ 9 ] noted that in 19 children a postauricular approach did not significantly affect pinna position. Shekhar and Bhavana [ 10 ] concluded that “behind the groove” incisions are better at preserving the conchomastoid angle than “in the groove” incisions and therefore give a better overall cosmetic result.…”

Benefícios do retalho osteoplástico pediculado como via de acesso em mastoidectomia para cirurgia de implante coclear

“…Existem trabalhos na literatura que avaliam o resultado estético da ferida operatória na cicatriz retroauricular para a cirurgia de implante coclear, utilizando a SBSES, sem validação para a língua portuguesa 60 . Uma das escalas que é validada para o português e utilizada para a avaliação de cicatrizes causadas por queimadura é a escala de Vancouver, mas esta também só avalia a percepção do examinador, sem considerar a do paciente 61 .…”