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Cervicofacial surgery and implantable hearing device extrusion: management of challenging cases

Published online by Cambridge University Press:  01 March 2021

C Carnevale ,
G Til-Pérez ,
D Arancibia-Tagle ,
M Tomás-Barberán  and
P Sarría-Echegaray
C Carnevale*
Affiliation:
Otorhinolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
G Til-Pérez
Affiliation:
Otorhinolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
D Arancibia-Tagle
Affiliation:
Otorhinolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
M Tomás-Barberán
Affiliation:
Otorhinolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
P Sarría-Echegaray
Affiliation:
Otorhinolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
*
Author for correspondence: Dr Claudio Carnevale, Servicio ORL, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, 07210, Palma de Mallorca, Islas Baleares, Spain E-mail: claudio.carnevale.orl@gmail.com
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Abstract

Objective

To describe our management of implantable hearing device extrusion in cases of previous cervicofacial surgery.

Methods

A review was conducted of a retrospectively acquired database of surgical procedures for implantable hearing devices performed at our department between January 2011 and December 2019. Cases of device extrusion and previous cervicofacial surgery are included. Medical and surgical management is discussed.

Results

Four cases of implant extrusion following cervicofacial surgery were identified: one involving a Bonebridge system and three involving cochlear implants. In all cases, antibiotic treatment was administered and surgical debridement performed. The same Bonebridge system was implanted in the middle fossa. The three cochlear implants were removed, and new devices were implanted in a more posterior region.

Conclusion

Previous cervicofacial surgery is a risk factor for hearing implant extrusion. The middle fossa approach is the best option for the Bonebridge system. Regarding the cochlear implant, it is always suitable to place it in a more posterior area. An inferiorly based fascio-muscular flap may be a good option to reduce the risk of extrusion.

Keywords

Hearing LossBone ConductionCochlear ImplantationPlastic SurgeryNeckBone Conduction Hearing
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 3 , March 2021 , pp. 212 - 216
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr C Carnevale takes responsibility for the integrity of the content of the paper

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