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Hamed N, Alahmadi A, Abdelsamad Y, Alballaa A, Almuhawas F, Allami H, Almousa H, Hagr A. A novel method for evaluating mastoid defect regrowth after cochlear implantation. Sci Rep 2024; 14:9194. [PMID: 38649424 PMCID: PMC11035648 DOI: 10.1038/s41598-024-59295-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
This retrospective study examined mastoid defects resulting from cochlear implant (CI) surgery and their potential for spontaneous regrowth across different age groups. Spontaneous closure of mastoid defects has been observed in certain CI patients during revision surgery or through post-operative temporal bone computer tomography (TB-CT). The analysis encompassed 123 CI recipients, comprising 81.3% children and 18.7% adults, who underwent post-operative TB-CT scans. Using image adjustment software, the study measured mastoid defect areas and found a significant reduction in children's defects between the initial and subsequent scans. Notably, mastoid defect areas differed significantly between children and adults at both time points. Furthermore, the analysis revealed significant correlations between mastoid defect areas and the age at implantation as well as the time elapsed since the CI surgery and the first CT scan. This study provides valuable insights for evaluating CI patients scheduled for revision surgery by assessing potential surgical challenges and duration. Furthermore, it may have a pivotal role in evaluating patients who experience postauricular swelling subsequent to CI surgery.
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Affiliation(s)
- Nezar Hamed
- King Abdullah Ear Specialist Center (KAESC), Department of Otorhinolaryngology, College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia.
| | - Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), Department of Otorhinolaryngology, College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
| | | | - Abdulaziz Alballaa
- King Abdullah Ear Specialist Center (KAESC), Department of Otorhinolaryngology, College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
| | - Fida Almuhawas
- King Abdullah Ear Specialist Center (KAESC), Department of Otorhinolaryngology, College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
| | - Hussain Allami
- King Abdullah Ear Specialist Center (KAESC), Department of Otorhinolaryngology, College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
| | - Hisham Almousa
- King Abdullah Ear Specialist Center (KAESC), Department of Otorhinolaryngology, College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), Department of Otorhinolaryngology, College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
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Abstract
HYPOTHESIS It was the aim of this study to establish normative data regarding intended changes in cochlear implants (CI) receiver positioning by one surgeon over time. BACKGROUND With the increasing number of CI patients, the probability of needing magnetic resonance imaging (MRI) increases. The accessibility of cerebral structures is limited by MRI artifacts caused by CI. New studies show a dependence of the visibility of intracranial structures by the MRI sequences and the position of the CI receiver itself. METHODS Retrospective and interindividual investigation of topograms with regard to the nasion-external auditory canal-internal magnet angle and the distance between the internal magnet and the external auditory canal. We evaluated scans of 150 CI recipients implanted from 2008 until 2015. RESULTS The most common implant position in the years 2008 to 2015 was a nasion-external auditory canal-internal magnet angle between 121 and 140 degrees (mean, 127 degrees) and an internal magnet-external auditory canal distance between 61 and 80 mm (mean, 70 mm). Over time the nasion-external auditory canal-internal magnet angle increased and the internal magnet-external auditory canal distance decreased, both to a statistically significant degree. A difference between the manufacturers was not observed. CONCLUSION The CI receiver position is important for an artifact-free examination of the internal auditory canal and the cochlea. The realization of the position over a time course supports awareness of artifact-related visibility limitations.
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Using autogenous mastoid cortical bone cap to cover the mastoidectomy defect during cochlear implantation. Int J Pediatr Otorhinolaryngol 2015; 79:419-22. [PMID: 25631936 DOI: 10.1016/j.ijporl.2015.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/02/2015] [Accepted: 01/08/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Assessment of autogenous mastoid cortical bone cap to cover the mastoidectomy defect via transmastoid and posterior tympanotomy approach surgical technique during cochlear implantation. METHODS A chart review of the autogenous mastoid cortical bone cap to cover the mastoidectomy defect via transmastoid and posterior tympanotomy approach surgical technique in 540 patients undergoing cochlear implantation was undertaken from January 2010 and December 2013 in Anhui Provincial Hospital. RESULTS The mastoidectomy defect was reconstructed using autogenous cortical bone cap in all cochlear implantation patients. No depression was found in the postauricular site. None of the patients had experienced any immediate or delayed postoperative infection complication such as wound infection, post-auricular abscess or intracranial complication. CONCLUSIONS The technique of autogenous mastoid cortical bone cap to cover the mastoidectomy defect is a good option during cochlear implantation via transmastoid and posterior tympanotomy approach. It can prevents depression of the postauricular site, and also may be able to prevent infection of the wound and the implanted processor. Autogenous cortical bone cap is easy to handle, ready available, stable, resorption resisting, also cost-saving in cochlear implantation surgery.
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Papsin BC, Wong DDE, Hubbard BJ, Cushing SL, Gordon KA. Exploring the relationship between head anatomy and cochlear implant stability in children. Cochlear Implants Int 2013; 12 Suppl 1:S14-8. [DOI: 10.1179/146701011x13001035752219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Heman-Ackah SE, Roland JT, Haynes DS, Waltzman SB. Pediatric cochlear implantation: candidacy evaluation, medical and surgical considerations, and expanding criteria. Otolaryngol Clin North Am 2012; 45:41-67. [PMID: 22115681 DOI: 10.1016/j.otc.2011.08.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Since the first cochlear implant approved by the US Food and Drug Administration in the early 1980s, great advances have occurred in cochlear implant technology. With these advances, patient selection, preoperative evaluation, and rehabilitation consideration continue to evolve. This article describes the current practice in pediatric candidacy evaluation, reviews the medical and surgical considerations in pediatric cochlear implantation, and explores the expanding criteria for cochlear implantation within the pediatric population.
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Affiliation(s)
- Selena E Heman-Ackah
- Department of Otolaryngology, New York University Cochlear Implant Center, New York University School of Medicine, 660 First Avenue, 7th Floor, New York, NY 10016, USA
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Soft tissue complications after pediatric cochlear implantation in children younger than 12 months. Otol Neurotol 2011; 32:780-3. [PMID: 21646937 DOI: 10.1097/mao.0b013e318214ea88] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Children are undergoing cochlear implantation younger than ever before. There has been some concern that young children may have an increased risk of soft tissue complications than older age groups. We aim to review the major and minor soft tissue complications after pediatric cochlear implantation in the age group of younger than 12 months. STUDY DESIGN Retrospective case review. METHODS Patients were identified from the cochlear implant program database of more than 1,000 children at the Hospital for Sick Children, Toronto, Canada. Demographic data, cause of hearing loss, and time of the onset of hearing loss were recorded. RESULTS A total of 66 patients were identified (94 implants) in the age group of younger than 12 months. Of these, there was 1 minor complication (implanted at 8 mo)-skin infection around implant 14 days later treated with antibiotics. There were no major complications. CONCLUSION Cochlear implantation in children younger than 12 months does not increase the risk of soft tissue complications.
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Campisi P, Hayward L, Papsin B. Mitek QuickAnchor fixation of cochlear implants using a minimal access technique. Int J Pediatr Otorhinolaryngol 2005; 69:1655-8. [PMID: 15964080 DOI: 10.1016/j.ijporl.2005.03.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2005] [Accepted: 03/29/2005] [Indexed: 11/26/2022]
Abstract
RATIONALE In children with thick cortical bone, surgical exposure for cochlear implant fixation is difficult when using a minimal access technique. We report our experience in these children using the Mitek QuickAnchor system. METHODS A retrospective review of all children undergoing cochlear implantation over a 12-month period was performed to identify those children in which a Mitek QuickAnchor was used. Measurements of cortical bone thickness at the receiver-stimulator well site were obtained from pre-operative CT scans of temporal bones of all children. The application of the Mitek QuickAnchor system was also reviewed. RESULTS Cochlear implant fixation using the Mitek QuickAnchor system was performed in 14 children (mean age 12 years) during the study period. The mean cortical bone thickness was 5.6mm in patients receiving the Mitek QuickAnchor system and 3.2mm in patients undergoing conventional fixation. The difference in cortical thickness was highly statistically significant. Successful secure fixation was obtained in all cases. CONCLUSIONS The Mitek QuickAnchor system provides an effective method of cochlear implant fixation when using a minimal access technique in children with thick cortical bone.
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Affiliation(s)
- P Campisi
- The Cochlear Implant Program and Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, The University of Toronto, 555 University Avenue, 6th Floor, Elm Wing, Toronto, Ontario, Canada M5G 1X8.
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