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Cochlear Implant Surgery (cochlear + implant_surgery)
Selected AbstractsManagement of Cerebrospinal Fluid Leakage From Cochleostomy During Cochlear Implant SurgeryTHE LARYNGOSCOPE, Issue 11 2006Christopher T. Wootten MD Abstract Objectives: The objectives of this retrospective review were to determine the incidence of cerebrospinal fluid (CSF) otorrhea from the cochleostomy during cochlear implant surgery, to recognize patients at risk, and to determine the appropriate preoperative, postoperative and intraoperative management. Methods: A chart review from two cochlear implant centers was performed to determine the incidence of CSF otorrhea, patients at risk, and appropriate management. Results: The incidence of CSF gusher is low, encountered in approximately 1% of patients undergoing cochlear implant surgery, and is seen in equal incidence in children and adults in our series. Preoperative imaging was predictive in only 50% of cases. Mechanisms for otorrhea in specific cochlear malformations and in those in which no apparent malformation exists are discussed. Successful implantation is expected in most cases. Intraoperative management may require complete packing of the middle ear space in addition to the cochleostomy to control CSF leak. Lumbar drain is rarely necessary. Outpatient management is possible in the majority of cases. Vaccination and antibiotic prophylaxis is essential. Conclusions: CSF otorrhea can be encountered in cochlear malformations and in cochleas without apparent malformation. Successful implantation without short-term or long-term complications is expected. [source] The Potential Risk of Carotid Injury in Cochlear Implant SurgeryTHE LARYNGOSCOPE, Issue 2 2002B. R. Gastman MD Abstract Background The advent of cochlear implantation has revolutionized the options afforded to the deaf population. With the increase in the prevalence of this procedure have come larger experiences in the associated technical challenges and complications. Results We present the evaluation and management of a patient with an unusual complication of improper placement of the implant electrode into the carotid canal and its management. We discuss the anatomy of the carotid artery and its proximity to the cochlea to emphasize the potential risk to this large vessel. Conclusions Damage to the carotid canal and the carotid artery is a potential risk of cochlear implant surgery. When available, we recommend intraoperative electrical testing of the cochlear implant be performed. If there is doubt as to the placement of the electrode, a radiograph should be obtained before the patient is taken out of the operating room to avoid this complication. [source] Ultracision: An Alternative to Electrocautery in Revision Cochlear Implant SurgeryTHE LARYNGOSCOPE, Issue 1 2002Roland Laszig MD No abstract is available for this article. [source] Incidence and indications for revision cochlear implant surgery in adults and children,THE LARYNGOSCOPE, Issue 1 2009Kevin D. Brown MD Abstract Objectives/Hypothesis: To identify the incidence of and common causes for cochlear implant revision. Study Design: Retrospective case series. Methods: Operative records were reviewed for all cases of revision cochlear implantation from 1992 to 2006. The causes for reimplantation were classified as hard device failure, soft device failure, exposure/infection, receiver/stimulator migration, and electrode migration. Manufacturers' failure analysis of explanted devices was likewise determined. Results: Eight hundred and six cochlear implants were performed during the study period including 44 (5.5%) revision procedures. The revision rate was 7.3% for children and 3.8% for adults and reached statistical significant difference. The most common reasons for revision were device failure (78%; 55% hard failure, 23% soft failure) followed by electrode migration (9%) and receiver/stimulator migration (7%). Manufacturers' analysis of failed devices revealed loss of hermetic seal and cracked cases to be the most common causes of failure. Bench analysis of 5/10 explanted devices that were soft failures demonstrated identifiable device defects. Conclusions: Revision cochlear implant surgery is an infrequent occurrence. Its incidence appears to be higher in children than in adults, although in this series does not appear to be due to increased wound complications, infections, or trauma. Explanted implants that have soft failure as the etiology may have demonstrable defects on bench testing. Laryngoscope, 119:152,157, 2009 [source] Management of Cerebrospinal Fluid Leakage From Cochleostomy During Cochlear Implant SurgeryTHE LARYNGOSCOPE, Issue 11 2006Christopher T. Wootten MD Abstract Objectives: The objectives of this retrospective review were to determine the incidence of cerebrospinal fluid (CSF) otorrhea from the cochleostomy during cochlear implant surgery, to recognize patients at risk, and to determine the appropriate preoperative, postoperative and intraoperative management. Methods: A chart review from two cochlear implant centers was performed to determine the incidence of CSF otorrhea, patients at risk, and appropriate management. Results: The incidence of CSF gusher is low, encountered in approximately 1% of patients undergoing cochlear implant surgery, and is seen in equal incidence in children and adults in our series. Preoperative imaging was predictive in only 50% of cases. Mechanisms for otorrhea in specific cochlear malformations and in those in which no apparent malformation exists are discussed. Successful implantation is expected in most cases. Intraoperative management may require complete packing of the middle ear space in addition to the cochleostomy to control CSF leak. Lumbar drain is rarely necessary. Outpatient management is possible in the majority of cases. Vaccination and antibiotic prophylaxis is essential. Conclusions: CSF otorrhea can be encountered in cochlear malformations and in cochleas without apparent malformation. Successful implantation without short-term or long-term complications is expected. [source] The Potential Risk of Carotid Injury in Cochlear Implant SurgeryTHE LARYNGOSCOPE, Issue 2 2002B. R. Gastman MD Abstract Background The advent of cochlear implantation has revolutionized the options afforded to the deaf population. With the increase in the prevalence of this procedure have come larger experiences in the associated technical challenges and complications. Results We present the evaluation and management of a patient with an unusual complication of improper placement of the implant electrode into the carotid canal and its management. We discuss the anatomy of the carotid artery and its proximity to the cochlea to emphasize the potential risk to this large vessel. Conclusions Damage to the carotid canal and the carotid artery is a potential risk of cochlear implant surgery. When available, we recommend intraoperative electrical testing of the cochlear implant be performed. If there is doubt as to the placement of the electrode, a radiograph should be obtained before the patient is taken out of the operating room to avoid this complication. [source] Localized erosive pustular dermatosis of the scalp at the site of a cochlear implant: successful treatment with topical tacrolimusCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2009A. V. Marzano Summary Erosive pustular dermatosis of the scalp (EPDS) is a rare form of nonmicrobial pustulosis mainly occurring in elderly patients with long-term sun damage to the skin. Clinically, it is characterized by pustular lesions that progressively merge into erosive and crusted areas over the scalp. The histology of EPDS is nonspecific, and its pathophysiology remains undetermined, with various types of local trauma possibly acting as the triggering factor. We describe a 24-year-old woman who developed EPDS after cochlear implant surgery for profound sensorineural hearing loss. We speculate that either the cutaneous surgery during cochlear implantation or the skin inflammation that commonly occurs near the magnet might have triggered the disorder. It is of note that the patient's skin lesions healed completely after treatment with topical tacrolimus, a relatively novel immunosuppressive molecule. Thus, topical tacrolimus may be indicated as a therapeutic alternative to the widely used steroids for this disease, mainly to avoid steroid-related cutaneous atrophy. [source] Prophylactic effect of clarithromycin in skin flap complications in cochlear implants surgery,THE LARYNGOSCOPE, Issue 10 2009Juan Garcia-Valdecasas MD Abstract Objectives/Hypothesis: To assess the usefulness of postoperative clarithromycin versus classical postoperative prophylaxis with occlusive dressing to prevent cochlear implant skin flap complications. Study Design: Cohort study. Methods: Surgical site infections were compared in four groups: 1) ceramic/classical postoperative cares (21 patients), 2) titanium-silicon/classical postoperative cares (75), 3) ceramic/clarithromycin (24), and 4) titanium-silicon/clarithromycin (76). Preoperative ceftriaxone was systematically used in all patients in all four groups. Patients were followed up for at least 4 months. Attributable risk and number needed to treat were calculated. Results: All infections appeared in titanium-silicon covered implants, and the risk of surgical site infection was 8.1 times higher in patients treated only with ceftriaxone and classical postoperative prophylaxis compared to those also given clarithromycin. Eleven patients needed to receive clarithromycin to avoid surgical infection. Conclusions: Long-term treatment with low-dose clarithromycin may reduce the incidence of surgical site infections. Laryngoscope, 2009 [source] | ||||||||||