Department of Otorhinolaryngology, Stefan Zeromski Specialist Hospital, Cracow, Poland.
Clarós Otorhinolaryngology Clinic, Cochlear Implant Center, Barcelona, Spain.
Acta Otolaryngol. 2020 Jul;140(7):544-547. doi: 10.1080/00016489.2020.1744721. Epub 2020 Mar 30.
Cochlear implant extrusion as a result of infection is an uncommon, but serious complication, which can lead to implant removal as the ultimate solution. (1) to identify the incidence of cochlear implant extrusion and its causes, (2) to report our management of patients presenting skin complications after cochlear implant surgery (3) to propose new therapeutical options with hyperbaric oxygen therapy (HBOT). A retrospective analysis of medical documentation of 1250 patients who were operated on with cochlear implants in our department between 1993 and 2015. The medical charts of 25 patients were selected due to reported skin flap complications resulting in CI extrusion. Five of those patients were subsequently removed from the study because of no infection signs. Non-traumatic cochlear implant extrusion occurred in 1.6% of implanted patients, and secondary treatment was effective in 90% of all cases (18 of 20 patients). HBOT as additional treatment was applied in 9 patients. Hyperbaric oxygen therapy can be considered as safe adjuvant treatment option in individual cases of proceeding with cochlear implant extrusion with signs of wound infection. HBOT may contribute to reducing the need for cochlear implant explantation due to infectious skin flap complication.
由于感染导致的耳蜗植入体脱出是一种罕见但严重的并发症，可能导致最终需要移除植入体。（1）确定耳蜗植入体脱出的发生率及其原因，（2）报告我们对接受耳蜗植入术后出现皮肤并发症的患者的处理方法，（3）提出使用高压氧治疗（HBOT）的新治疗选择。对 1993 年至 2015 年间在我科接受耳蜗植入手术的 1250 例患者的医疗记录进行回顾性分析。由于报告的皮瓣并发症导致 CI 脱出，选择了 25 名患者的病历。其中 5 名患者由于没有感染迹象而随后被排除在研究之外。非创伤性耳蜗植入体脱出在植入患者中发生率为 1.6%，所有病例中 90%（20 名患者中的 18 名）的二级治疗有效。在 9 名患者中应用了高压氧治疗作为附加治疗。高压氧治疗可作为有感染性皮瓣并发症的进展性耳蜗植入体脱出的安全辅助治疗选择。高压氧治疗可能有助于减少因感染性皮瓣并发症而需要取出耳蜗植入体。
