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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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Riepl R, Wigand MCC, Halbig AS, Werz J, Emmanuel B, Stupp F, Hoffmann TK, Goldberg-Bockhorn E. [Emphysema after cochlear implantation - risk factors and therapeutic options]. Laryngorhinootologie 2023; 102:16-26. [PMID: 36395786 DOI: 10.1055/a-1896-1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In case of cochlear implantation seroma, hematoma, local wound infections or vertigo are rare but typical complications. In contrast, emphysema is seldom reported. They can occur after cochlear implantation both in the postoperative healing phase and years later. A therapeutic algorithm does not yet exist. METHODS We report on 3 patients with subcutaneous emphysema in the area of the receiver-stimulator. An unsystematic review of the literature of cases with emphysema after cochlear implantation highlights possible risk factors and the therapeutic options. RESULTS The 3 cases developed subcutaneous emphysema 2-11 month after cochlear implantation due to nose blowing or CPAP therapy in obstructive sleep apnea. The current literature reports another 35 cases of emphysema after cochlear implantation. Air insufflation via the Eustachian tube is the most frequently described cause. Diseases of the nose and sinuses, tube dysfunction and obstructive sleep apnea are potential risk factors. Pressure bandage, puncture, tympanic tubes, and surgical revision are common treatments. CONCLUSIONS Most emphysema can be controlled by conservative methods such as pressure bandaging and behavioral instruction. Punctures should be avoided due to the risk of upcoming infections. The prophylactic use of antibiotics seems dispensable. Surgical revision should be considered especially in cases of pneumocephalus with suspected leakage in the dura. The coverage of the mastoidectomy by a bony cap can be precautious and beneficial in cases with risk factors.
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Affiliation(s)
- Ricarda Riepl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
| | - Marlene Corinna Cosima Wigand
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
| | - Anna-Sophia Halbig
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
| | - Julia Werz
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
| | - Benjamin Emmanuel
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
| | - Franziska Stupp
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
| | - Thomas Karl Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
| | - Eva Goldberg-Bockhorn
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Frauensteige 12, 89075 Ulm, Universitätsklinikum, Germany
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Thomas JMN, Gluth MB. Reconstruction of Mastoid Cortex Defects with Hydroxyapatite Cement for Negative Sequelae of Mastoidectomy. Ann Otol Rhinol Laryngol 2020; 130:338-342. [PMID: 32819142 DOI: 10.1177/0003489420952463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Mastoid cortex defects resulting from mastoidectomy surgery can rarely lead to negative sequelae, including unsightly post-auricular depression and discomfort. This study sought to evaluate the use of hydroxyapatite cement (HAC) to reconstruct mastoidectomy cortex defects. METHODS Retrospective chart review was undertaken for all patients that underwent reconstruction of the mastoid cortex using HAC at a single tertiary medical center between 2013 and 2019. Collected data included demographics, indications for mastoidectomy, complications, and associated symptom status. RESULTS Twenty-nine patients that underwent mastoid cortex repair using HAC were included, and ten of these underwent mastoid revision in a secondary procedure to reconstruct the mastoid cortex with a specific goal to eliminate negative signs and symptoms. There were no associated postoperative complications and no instances of post-auricular depression following repair. All cases of secondary reconstruction resolved the primary signs and symptoms that prompted mastoid revision. CONCLUSIONS HAC mastoid cortex reconstruction may be a safe and effective method to resolve negative sequelae resulting from previous mastoidectomy defects. Also, upfront HAC mastoid cortex reconstruction appears viable in select instances as an option to prevent potential future complications.
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Affiliation(s)
| | - Michael Brian Gluth
- University of Chicago Section of Otolaryngology-Head and Neck Surgery, Chicago, IL, USA
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Sun JQ, Sun JW, Hou XY. Cochlear implantation in Mondini's deformity: could the straight electrode array with length of 31 mm be fully inserted? Acta Otolaryngol 2017; 137:712-715. [PMID: 28498076 DOI: 10.1080/00016489.2017.1280849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSIONS The straight electrode array with length of 31 mm can be fully inserted using round window insertion in cochlear implantation with Mondini's deformity. It is a safe and effective process, but also a challenging task of the full implantation in children with Mondini's deformity. OBJECTIVE The aim of this study is to discuss whether the straight electrode array with a length of 31 mm could be fully inserted in cochlear implantation with Mondini's deformity. METHODS A chart review of 30 patients undergoing cochlear implantation with Mondini's deformity using the electrode array with length of 31 mm was undertaken from January 2012 and December 2015 in Anhui Provincial Hospital. RESULTS Full insertion of the straight electrode array with length of 31 mm were performed successfully in all patients with Mondini's deformity using round window insertion. Resistance was not encountered while introducing the electrodes. Ten of 30 patients had cerebrospinal fluid drainage during cochlear implantation. Cerebrospinal fluid drainage was controlled with small pieces of temporalis fascia packing round window in all patients. Intra-operative neural response telemetry was performed in all patients, and results were good. The result of X-ray showed proper placement of the cochlear implant electrode array. During surgery, no patients had experienced any immediate or delayed post-operative complications such as wound infection, intracranial complication, extrusion, or migration of the implant during an average follow-up period of 6-36 months.
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Affiliation(s)
- Jia-Qiang Sun
- Department of Otolaryngology-Head and Neck Surgery, Anhui provincial hospital, Hefei, Anhui Province, PR China
| | - Jing-Wu Sun
- Department of Otolaryngology-Head and Neck Surgery, Anhui provincial hospital, Hefei, Anhui Province, PR China
| | - Xiao-Yan Hou
- Department of Otolaryngology-Head and Neck Surgery, Anhui provincial hospital, Hefei, Anhui Province, PR China
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