Tailed Palva flap in the subperiosteal pocket technique for cochlear implantation

Orhan, Kadir Serkan; Polat, Beldan; Enver, Necati; Güldíken, Yahya

doi:10.1017/s0022215115001905

Cited by 5 publications

(14 citation statements)

References 8 publications

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“…Two studies of the same medical center had overlapping patient cohorts. The study conducted in 2011 was excluded, because this study had the smallest number of participants (18,19). Six studies were excluded because it was unclear if the study population consisted of the minimum of 10 adult patients (20)(21)(22)(23)(24)(25).…”

Section: Results Of Searchmentioning

confidence: 99%

“…We included five retrospective reviews (18,26,(28)(29)(30) and two prospective, nonrandomized, observational trials (31,32). Follow-up varied across the retrospective studies from 6 days to 6 years, with only two studies reporting a minimum follow-up of 12 months (26,28).…”

Section: Study Design and Settingmentioning

confidence: 99%

“…Study population characteristics of age and sex were reported on group level for all studies, except Dees et al (31) who reported these data on participant level. Mean age of the adult study population was reported, or could be calculated from the raw data, for three studies, and ranged from 43.1 to 67.2 years (18,29,31). The total sample size of adult patients for all included studies was 430 (range 10-120 participants).…”

Section: Population Characteristics and Sample Sizementioning

confidence: 99%

“…Three studies (30)(31)(32) used exclusively one cochlear implant type: either Advanced Bionics HiFocus Mid-Scala, Cochlear Nucleus 512 implant or Neurelec Digisonic SP. All other studies included more than one type of cochlear implant (18,26,28,29). The R/S device of the cochlear implant was fixated with a bony bed without additional sutures in two studies (28,31).…”

Section: Interventions and Comparisonsmentioning

confidence: 99%

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Cochlear Implant Fixation Techniques: A Systematic Review of the Literature

Markodimitraki

Strijbos²,

Stegeman

et al. 2021

Otology &Amp; Neurotology

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Objective: Given the lack of consensus on fixation techniques of the cochlear implant, this review aims to create an up-to-date overview of intra-and postoperative complications, focusing on migration of the internal receiver/stimulator (R/S) device and the electrode array. Data Sources: On June 29, 2020 we conducted a search in PubMed, Embase, Cochrane, Web of Science, and CINAHL. Keywords were ''Cochlear implant,'' ''complication,'' ''migration,'' and synonyms. Study Selection: Studies were considered if: 1) the adult study population consisted of ! 10 patients, 2) the R/S device was fixated using the bony well or tight subperiostal pocket technique without bone-anchoring sutures or screws on the implant, and 3) migration of the R/S device or displacement of the electrode array were described as outcomes. Data Extraction: Study characteristics, interventions, followup, and outcomes were extracted. For critical appraisal, an adapted version of the Newcastle-Ottawa quality assessment scale for cohort studies was used. Data Synthesis: Seven studies were included (n ¼ 430 patients). Migration of the R/S device was reported by three studies. Two studies applying the tight pocket technique reported migration rates ranging from 9.0 to 69.2%. One study using the bony bed technique reported migration of 100%, with an average of 2.5 mm. All studies lacked the required standard for comparability, assessment of outcome, and follow-up. Conclusions and Relevance: There is currently no evidence of a difference between the bony bed-and tight pocket fixation technique, regarding migration of the R/S device or the electrode array, in adult patients.

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Section: Results Of Searchmentioning

confidence: 99%

Section: Study Design and Settingmentioning

confidence: 99%

Section: Population Characteristics and Sample Sizementioning

confidence: 99%

Section: Interventions and Comparisonsmentioning

confidence: 99%

See 2 more Smart Citations

Cochlear Implant Fixation Techniques: A Systematic Review of the Literature

Markodimitraki

Strijbos²,

Stegeman

et al. 2021

Otology &Amp; Neurotology

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“…Many techniques of raising a periosteal flap have been described. Orhan et al [6] described a Tailed Palva flap technique in which the superior incision of the standard Palva flap was extended 2 cms posteriorly. Fouad et al [7] reported another modification of the Palva flap by extending the superior incision posteriorly and inferiorly to create a second inferiorly based flap.…”

Section: Resultsmentioning

confidence: 99%

An Easy to use Periosteal Flap for Cochlear Implantation: Experience from a Tertiary Care Centre

Panda

Hage

Verma

et al. 2020

Indian J Otolaryngol Head Neck Surg

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This report describes a novel and easy periosteal flap design for cochlear implantation. This technique has been used in 37 patients between June 2019 and August 2020. The patients have been followed up for a period of 2 months to 15 months. There were no flap related complications attributed to this flap. There was no wound hematoma, wound breakdown or implant migration. The flap design is safe, easy, less time consuming and results in better coverage of the receiver stimulator unit without any tension.

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Comparison of Cochlear Implant Device Fixation—Well Drilling Versus Subperiosteal Pocket. A Cost Effectiveness, Case–Control Study

Shavit¹,

Weinstein

Drusin³

et al. 2020

Otology &Amp; Neurotology

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Objective: To compare surgical characteristics and complications between well drilling (WD) and subperiosteal pocket techniques (SPT) for receiver/stimulator (R/S) fixation of cochlear implant (CI), and conduct cost-effectiveness analysis. Study Design: Retrospective clinical study, decision-analysis model. Setting: Tertiary referral center. Patients: Three-hundred and eighty-eight CI recipients with a minimum of 6-months follow-up. Interventions: CI surgery using either WD or SPT for R/S fixation. A decision-analysis model was designed using data from a systematic literature review. Main Outcome Measures: Surgical operation time, rates of major and minor long-term complications were compared. Incremental cost-effectiveness was also estimated, comparing the two methods of fixation. Results: We compared 179 WD with 209 SPT. Surgery time was significantly shorter in SPT (148 versus 169 min, p = 0.001) and remained significant after adjustment for possible confounders. Higher rates of major complications requiring surgical intervention were found with SPT (10.5% versus 4.5%, p = 0.042), however, the difference was not significant after adjusting for follow-up time (47.8 versus 32.5 months for SPT, WD respectively; p < 0.001). The incremental cost-effectiveness ratio for WD (compared with SPT) was $48,795 per major complication avoided, which was higher than the willingness-to-pay threshold of $47,700 (average cost of 2 h revision surgery). Conclusions: SPT was found to be faster but potentially risks more complications, particularly relating to device failure. Further long-term studies are required to validate these differences. Based on data from the current literature, neither of the methods is compellingly cost-effective over the other, and surgeons can base their choice on personal preference, comfort, and previous training.

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Tailed Palva flap in the subperiosteal pocket technique for cochlear implantation

Abstract: This study shows that the tailed Palva incision facilitates easy insertion of the implant and, by creating a one-way obscured pocket, this technique also enhances stabilisation of the receiver-stimulator, thereby avoiding anterior migration.

Cited by 5 publications

References 8 publications

Cochlear Implant Fixation Techniques: A Systematic Review of the Literature

Cochlear Implant Fixation Techniques: A Systematic Review of the Literature

An Easy to use Periosteal Flap for Cochlear Implantation: Experience from a Tertiary Care Centre

Comparison of Cochlear Implant Device Fixation—Well Drilling Versus Subperiosteal Pocket. A Cost Effectiveness, Case–Control Study

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