Swelling around the implant body: A late complication of cochlear implantation. How to deal?

Çatlı, Tolgahan; Olgun, Yüksel; Çelik, Çağrı; Gur, H. Deniz; Bayrak, Asuman Feda; Olgun, Levent

doi:10.1179/1754762814y.0000000084

Cited by 11 publications

(13 citation statements)

References 11 publications

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“…However, we found no obvious predisposing factors in four patients (33.3%); swelling around the receiver was both sudden and spontaneous. The same situation has also been reported by Gawecki et al [ 1 ] and Catli et al [ 8 ]; some patients lack causative predisposing factors.…”

Section: Discussionsupporting

confidence: 85%

“…Also, the scalps of children are thin and excessive magnetic strength is a serious risk factor for flap necrosis. Poor sanitary conditions can also lead to flap infection [ 1 , 8 , 10 ]. The main issues that we encountered included foreign body reactions (3/12, 25%), strong magnetic attraction (2/12, 16.7%), upper respiratory tract infection (2/12, 16.7%), and a history of head trauma (2/12, 16.7%) prior to swelling.…”

Section: Discussionmentioning

confidence: 99%

“…Flap issues are associated with a range of risk factors, including age at implantation, delayed allergic reactions, poor systemic condition, re-implantation, poor hygiene, acute otitis media, bacterial biofilm formation, upper respiratory infection, head trauma, and strong magnet strength [1,[7][8][9]. Most of our CI patients were children; flap complications are more common in children [4], who are also susceptible to respiratory tract infections and at higher risk of acute otitis media.…”

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: 85%

Section: Discussionmentioning

confidence: 99%

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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“…Fluid retention around implants often include hematoma and seroma ( Catli et al., 2015 ). The incidence rate of fluid retention around implants in our series was 3.5%.…”

Section: Discussionmentioning

confidence: 99%

After cochlear implantation: Complications related to flap around implants

Qin

Qiu

et al. 2016

Journal of Otology

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ObjectiveTo report complications related to flap around implants after cochlear implantation, possible causes of such complications and treatments.Methods and materialWe performed a retrospective analysis of children in whom complications related to flap around implants occurred after undergoing cochlear implantation in our department from 2005 to 2016.ResultsComplications among 1500 cochlear implantation (CI) recipients by the same surgeon included hematoma (n = 20) and seroma around implants (n = 15), of which most (n = 10) recovered in 2 weeks after effective drainage, utility of antibiotics and pressure dressing, but 5 developed flap necrosis and had to undergo contralateral re-implantation. Four patients developed abscess around implants, of whom 2 recovered after 2 weeks of drainage, gentamicin irrigation and use of antibiotics, but 2 patients ended up with flap necrosis and had to receive contralateral reimplantation.ConclusionsImmediate drainage, pressure dressing and antibiotics can be used to effectively control seroma around implants. For seroma lasting for more than two weeks without improvement, surgical drainage may be need.

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“…In this regard, transcutaneous ultrasound is a valuable imaging modality that avoids radiation exposure and has been described for the diagnostic workup of haematoma around the CI and for detecting magnet dislocation [16][17][18]. However, the literature on the feasibility and reliability of ultrasound in other CI complications has so far been limited to a few case reports [13,19,20].…”

Section: Discussionmentioning

confidence: 99%

Diagnosing complications following cochlear implantation using transcutaneous ultrasound

Rupp

Thimsen

Balk

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose The aim of this study was to investigate the feasibility and reliability of transcutaneous ultrasound for the detection of complications after cochlear implantation. Methods In a single center retrospective cohort study, 115 consecutive cases of suspected complications after cochlear implantation (intervention group) were examined. The rate of pathologic ultrasound findings for specific leading symptoms and diagnoses was compared to a control group comprising twenty consecutive cochlear implants in symptom-free patients. Results Diagnostic ultrasound showed distinctly more pathologic findings in the intervention group (n = 67; 58.3%; p < 0.001) compared to the control group (n = 1; 5%). Ultrasound revealed significantly more pathologic findings in haematoma or seroma around the implant (n = 17; 100%; p < 0.001; ϕ = 0.94) and magnet dislocation (n = 44; 97.7%; p < 0.001; ϕ = 0.92) confirmed by a strong effect. Ultrasound examination showed a medium to high effect size in patients presenting with local infections (n = 3; 21.4%; p = 0.283; ϕ = 0.25) and skin flap oedema (n = 2; 50%; p = 0.061; ϕ = 0.51). In contrast, ultrasound examinations displayed a low effect size in undefined cephalgia (0%; p = 0.444; ϕ = 0.17) and device malfunction or failure (0%; p > 0.999; ϕ = 0.13). Conclusion Transcutaneous ultrasound can be advocated as a feasible and effective method in the diagnostic work-up of magnet dislocation and haematoma or seroma around the implant following cochlear implantation. Contrary, ultrasound findings can be expected to be inconspicuous in patients presenting with undefined cephalgia and device malfunction or failure.

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Swelling around the implant body: A late complication of cochlear implantation. How to deal?

Cited by 11 publications

References 11 publications

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

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

After cochlear implantation: Complications related to flap around implants

Diagnosing complications following cochlear implantation using transcutaneous ultrasound

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