Cochlear Implantation in Canal Wall Down Mastoid Cavities

The use of a simultaneous fascia lata‐free flap with cochlear implantation after radical Mastoidectomy

Patients undergoing cochlear implant after prior radical mastoidectomy are at increased risk of device infection requiring device explant. Various techniques including two‐stage operations have been used. We report the novel technique with use of a vascularized fascia lata free flap for a patient undergoing cochlear implantation with radical mastoidectomy.

[The Impact of Subtotal Petrosectomy in Cochlea Implantation]

INTRODUCTION

Cochlear Implantation (CI) in patients with chronic otitis media or existing open mastoid cavity can be challenging. Subtotal petrosectomy (STP) is an option to improve the safety of this procedure.

MATERIAL AND METHODS

Retrospective study with cases of STP prior CI.

RESULTS

25 patients could be enrolled in this investigation. Over all 26 STP were performed approximately 6 months before CI. The majority of the patients suffered from a chronic otitis media or had a preexisting open cavity; in one case a complex temporal bone fracture with destruction of the external auditory canal was the reason for this technique. After STP we observed three times a delayed wound healing at the closure of the external auditory meatus and a bleeding at the periumbilical region after harvesting fat of the abdominal wall. All patients could be provided with a CI. A recurrence of a cholesteatoma did not appear so far.

CONCLUSION

With this method CI is feasible even in cases of concurrent chronic otitis media or canal wall down situation. We are in favour of a staged procedure, nevertheless a simultaneous STP and CI is justifiable in individual patients.