Cochlear implant flap necrosis: adjunct hyperbaric oxygen therapy for prevention of explantation

The most common complication resulting from cochlear implant surgery involves the skin flap: scalp breakdown, flap necrosis, and implant exposure requiring explantation. A 5.4 percent flap complication rate has been reported with the C-shaped postauricular flap (anteriorly-based on the superficial t...

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Bibliographic Details
Published inThe American journal of otology (New York, N.Y.) Vol. 12; no. 1; p. 71
Main Authors Schweitzer, V G, Burtka, M J
Format Journal Article
LanguageEnglish
Published United States 01.01.1991
Subjects
Adult
Cochlear Implants
Female
Humans
Hyperbaric Oxygenation
Necrosis
Postoperative Complications - pathology
Surgical Flaps - pathology
Surgical Wound Infection - prevention & control
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Summary:The most common complication resulting from cochlear implant surgery involves the skin flap: scalp breakdown, flap necrosis, and implant exposure requiring explantation. A 5.4 percent flap complication rate has been reported with the C-shaped postauricular flap (anteriorly-based on the superficial temporal and occipital arteries) in contrast to a 0 percent flap complication rate with the Australian inverted U-flap (inferiorly-based on the occipital artery). The literature is scant concerning detailed management of flap necrosis in order to obviate cochlear implant removal. Presented is an illustrative case of full thickness C-shaped flap necrosis with resultant exposure of a Nucleus multichannel implant. Successful wound management required pre- and postoperative hyperbaric oxygen in conjunction with a transposition flap closure of the scalp defect. Cochlear explantation was not necessary and rehabilitation and implant function were excellent 18 months postoperatively.
ISSN:0192-9763