Hovev Zohar, Silberstein Eldad, Kaplan Daniel Michael
Department of Otolaryngology-Head and Neck Surgery, Soroka Medical Center and the Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel.
Department of Plastic Surgery, Soroka Medical Center and the Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel.
Cochlear Implants Int. 2024 Mar;25(2):147-153. doi: 10.1080/14670100.2024.2306442. Epub 2024 Feb 26.
Skin breakdown over receiver/stimulator (RS) after cochlear implantation poses a serious challenge. We report our experience using a one-stage reconstruction and implant salvage approach.
Between the years 2005 and 2017 five children, all females, with congenital- bilateral sensorineural hearing loss were identified. In all cases, a temporoparietal fascia flap (TPFF) and a large scalp flap were used to provide a two-layer coverage to the exposed RS. In the first three cases, a split-thickness skin graft was used to cover the donor site defect. In the latter two cases, a larger rotation flap was used, and a skin graft was not required. One case required revision due to the dehiscence of the wound and exposure of the RS. In another case, an accidental electrode array explantation occurred and the patient underwent a revision cochlear implantation. All patients had achieved complete healing and no change in hearing thresholds with the implants.
We demonstrate our one-stage salvage technique with TPFF that saves the implant and prevents a two-stage procedure. The success rate can be improved with special care at reconstruction and with better protection of the implant during the procedure.
人工耳蜗植入术后受话器/刺激器（RS）处的皮肤破损是一个严峻的挑战。我们报告了采用一期重建和植入物挽救方法的经验。
在2005年至2017年期间，确定了5名先天性双侧感音神经性听力损失的儿童，均为女性。在所有病例中，均使用颞顶筋膜瓣（TPFF）和大型头皮瓣为暴露的RS提供双层覆盖。在前3例中，使用中厚皮片覆盖供区缺损。在后2例中，使用了更大的旋转皮瓣，无需植皮。1例因伤口裂开和RS暴露需要翻修。在另一例中，发生了意外的电极阵列取出，患者接受了翻修人工耳蜗植入。所有患者均实现完全愈合，植入物的听力阈值无变化。
我们展示了使用TPFF的一期挽救技术，该技术可挽救植入物并避免二期手术。通过在重建过程中特别小心以及在手术期间更好地保护植入物，可以提高成功率。
