Zwierz Aleksander, Masna Krystyna, Burduk Paweł, Hackenberg Stephan, Scheich Matthias
Department of Otolaryngology, Phoniatrics and Audiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland.
Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, 97080 Würzburg, Germany.
Audiol Res. 2024 Mar 1;14(2):280-292. doi: 10.3390/audiolres14020025.
The subtotal petrosectomy procedure may be useful for cochlear implantation in selected patient groups. Although it is highly effective, complications can arise, which may have economic implications for the patient due to the high cost of the device. Therefore, several authors have attempted to identify the most effective concept for obliteration. We present a pilot descriptive study of application techniques for obliterating cavities after subtotal petrosectomy using a temporoparietal fascial flap (TPFF) modified with injectable platelet-rich fibrin (IPRF+) for three cochlear implant (CI) patients. Our concept preserves important anatomical structures, such as the temporalis muscle, which covers the CI receiver-stimulator. Injection of IPRF+ also increases the available tissue volume for obliteration and enhances its anti-inflammatory and regenerative potential. To the best of our knowledge, the use of TPFF for filling the cavity has not been adopted for CI with SP and for blind sac closure. Our literature review and our experience with this small group of patients suggest that this procedure, when combined with IPRF+ injections, may reduce the risk of potential infection in the obliterated cavity, particularly when used with CI. This technique is applicable only in cases when the surgeons are convinced that the middle ear cavity is purged of cholesteatoma.
部分岩骨切除术对于特定患者群体的人工耳蜗植入可能是有用的。尽管其效果显著，但可能会出现并发症，由于设备成本高昂，这可能给患者带来经济负担。因此，一些作者试图确定最有效的封闭概念。我们对3例人工耳蜗植入（CI）患者进行了一项前瞻性描述性研究，采用注射用富血小板纤维蛋白（IPRF+）改良的颞顶筋膜瓣（TPFF）对部分岩骨切除术后的腔隙进行封闭的应用技术。我们的理念保留了重要的解剖结构，如覆盖CI接收器-刺激器的颞肌。注射IPRF+还增加了用于封闭的可用组织体积，并增强了其抗炎和再生潜力。据我们所知，TPFF用于填充腔隙尚未应用于伴有胆脂瘤的人工耳蜗植入及盲袋封闭。我们的文献综述以及对这一小群患者的经验表明，该手术与IPRF+注射相结合，可能会降低封闭腔隙潜在感染的风险，尤其是在人工耳蜗植入时使用。该技术仅适用于外科医生确信中耳腔已清除胆脂瘤的情况。
