Methods for measuring pre-, intra-, and postoperative skin thickness for cochlear implants

Zaubitzer, Lena; Schaefer, Elena; Wallhaeuser-Franke, Elisabeth; Burkart, Johannes; Herrmann, Katrin; Walter, Beatrice; Schell, Angela; Scherl, Claudia; Servais, J; Haeussler, Daniel

doi:10.1016/j.joto.2021.12.001

Cited by 3 publications

(3 citation statements)

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“…However, surgeons are reluctant to carry out an SFR surgery in a patient with thick skin scalp because of increased risk of infection, skin necrosis, abscess formation, and CI extrusion (5,7). Several studies have found a positive correlation between skin thickness and magnet strength, and skin thickness and BMI (4,6,(8)(9)(10). Nevertheless, patients with normal BMI (patients 4 and 6) might also have scalp thickness >7 mm, putting them at risk of magnet retention issues.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a thick scalp increases the distance between these magnets, which can also create retention issues. Most CI manufacturers advise a skin thickness no greater than 7 mm to allow proper magnet retention (4). However, surgeons are reluctant to carry out an SFR surgery in a patient with thick skin scalp because of increased risk of infection, skin necrosis, abscess formation, and CI extrusion (5,7).…”

Section: Discussionmentioning

confidence: 99%

“…The external hardware of the CI contains the microphone, sound processor, and transmitter, and the implanted part consists of the receiver coil, stimulator, and multichannel electrode (3). Both the external transmitter and the internal receiver coil contain a magnet that guarantees the placement of the transmitting coil over the receiver coil and the transmission of electrical signals (4). Thus, weak magnet strength and thick skin flap overlying the receiver coil may pose a retention problem for CI patients.…”

Section: Introductionmentioning

confidence: 99%

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Triamcinolone Injection for Cochlear Implant Magnet Adherence Issues

et al. 2023

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Objectives To evaluate the effectiveness of triamcinolone injections in treating external magnet displacement in cochlear implant (CI) patients with adhesions problems of their processor. Patients We present seven CI patients with magnet adhesion issues who presented to our tertiary care neurotology clinic. None of the patients had a history of head trauma, postimplant MRI, or surgery in the head and neck other than the cochlear implantation. Intervention Triamcinolone 40 mg/mL injected subcutaneously at the CI magnet site. Main Outcome Measure Reduction of scalp thickness and successful magnet retention. Results Our cohort consisted of seven patients (eight implant sites) of which five were overweight or obese. The temporoparietal scalp thickness measured on preoperative CT scans varied between 8.4 and 15.9 mm. Initial conservative measures such as hair shaving at the magnet site, using a headband, and increasing magnet strength failed in all patients. After receiving triamcinolone injections at the CI receiver site, six out of seven patients (seven out of eight CI sites) were able to use their processor again without the need for a headband for an average of 9.55 hours/day. The average number of injections required for each patient was 2.57 (SD = 2.18), median (range) = 1 (1–7). One patient required a flap thinning surgery but showed no improvement even after flap thinning. None of the patients showed skin irritation, breakdown, ulceration, necrosis, or magnet exposure during follow-up period. Conclusions The significant improvement in CI retention shows that triamcinolone injections are effective in making the subcutaneous tissue thinner and allowing magnet retention.

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