Schweitzer V G, Burtka M J
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202.
Am J Otol. 1991 Jan;12(1):71-5.
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.
头皮破溃、皮瓣坏死以及植入物暴露需要取出。据报道，C形耳后皮瓣（基于颞浅动脉和枕动脉向前）的皮瓣并发症发生率为5.4%，相比之下，澳大利亚倒U形皮瓣（基于枕动脉向下）的皮瓣并发症发生率为0%。关于皮瓣坏死的详细处理以避免取出人工耳蜗的文献很少。本文介绍了一例全层C形皮瓣坏死导致Nucleus多通道植入物暴露的病例。成功的伤口处理需要术前和术后高压氧治疗，并结合头皮缺损的转位皮瓣闭合。无需取出人工耳蜗，术后18个月康复情况和植入物功能良好。
