Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-23T04:12:20.876Z Has data issue: false hasContentIssue false

The effect of cochlear implant bed preparation and fixation technique on the revision cochlear implantation rate

Published online by Cambridge University Press:  11 June 2018

A E Pamuk*
Affiliation:
Department of Otorhinolaryngology, Akyurt State Hospital, Ankara, Turkey
G Pamuk
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
S Jafarov
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
M D Bajin
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
S Saraç
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Koç University, Istanbul, Turkey
L Sennaroğlu
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
*
Address for correspondence: Dr Ahmet Erim Pamuk, Department of Otorhinolaryngology, Akyurt State Hospital, 06750 Akyurt, Ankara, Turkey Fax: +90 312 844 3016 E-mail: [email protected]

Abstract

Objective

This study aimed to determine the effect of the subperiosteal tight pocket technique versus the bone recess with suture fixation technique on the revision cochlear implantation rate and complications.

Methods

This retrospective study included 1514 patients who underwent cochlear implantation by 2 senior surgeons between October 2002 and January 2016. Revision cases were identified and analysed.

Results

In all, 52 patients (3.34 per cent) underwent revision cochlear implantation. The revision rate was 7.18 per cent in the subperiosteal tight pocket group versus 2.37 per cent in the bone recess with suture fixation group (p < 0.001). Device failure was the most common reason for revision surgery in both groups. There was a significant difference in the device failure rate between the bone recess with suture fixation group (2.11 per cent) and subperiosteal tight pocket group (6.88 per cent) (p < 0.001).

Conclusion

Accurate fixation of the cochlear implant receiver/stimulator is crucial for successful cochlear implantation. As the bone recess with suture fixation technique is associated with a lower revision rate and a similar complication rate as the subperiosteal tight pocket technique, it should be the preferred fixation technique for cochlear implantation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr A E Pamuk takes responsibility for the integrity of the content of the paper

References

1Adunka, OF, Buchman, CA. Cochlear implant fixation in children using periosteal sutures. Otol Neurotol 2007;28:768–70CrossRefGoogle ScholarPubMed
2Cohen, NL, Kuzma, J. Titanium clip for cochlear implant electrode fixation. Ann Otol Rhinol Laryngol Suppl 1995;166:402–3Google Scholar
3Djalilian, HR, King, T, Faust, RA, Smith, S, Levine, SC. Securing cochlear implants to the skull: two alternate methods. Ear Nose Throat J 2001;80:171–3Google Scholar
4Rudel, C, Zollner, W. Ionomeric cement–a bone glue for device fixation. Ear Nose Throat J 1994;73:189–91CrossRefGoogle ScholarPubMed
5Balkany, TJ, Hodges, AV, Buchman, CA, Luxford, WM, Pillsbury, CH, Roland, PS et al. Cochlear implant soft failures consensus development conference statement. Otol Neurotol 2005;26:815–18CrossRefGoogle ScholarPubMed
6Sennaroglu, L, Sarac, S, Turan, E. Modified minimal access surgery for MedEl and Clarion cochlear implants. Laryngoscope 2005;115:921–4CrossRefGoogle ScholarPubMed
7Davids, T, Ramsden, JD, Gordon, KA, James, AL, Papsin, BC. Soft tissue complications after small incision pediatric cochlear implantation. Laryngoscope 2009;119:980–3Google Scholar
8Shelton, C, Warren, FM. Minimal access cochlear implant fixation: temporalis pocket with a plate. Otol Neurotol 2012;33:1530–4Google Scholar
9O'Donoghue, GM, Nikolopoulos, TP. Minimal access surgery for pediatric cochlear implantation. Otol Neurotol 2002;23:891–4Google Scholar
10Yoshikawa, N, Hirsch, B, Telischi, FF. Cochlear implant fixation and dura exposure. Otol Neurotol 2010;31:1211–14Google Scholar
11Jethanamest, D, Channer, GA, Moss, WJ, Lustig, LR, Telischi, FF. Cochlear implant fixation using a subperiosteal tight pocket without either suture or bone-recess technique. Laryngoscope 2014;124:1674–7CrossRefGoogle ScholarPubMed
12Güldiken, Y, Orhan, KS, Yigit, O, Basaran, B, Polat, B, Gunes, S et al. Subperiosteal temporal pocket versus standard technique in cochlear implantation: a comparative clinical study. Otol Neurotol 2011;32:987–91CrossRefGoogle ScholarPubMed
13Sunde, J, Webb, JB, Moore, PC, Gluth, MB, Dornhoffer, JL. Cochlear implant failure, revision, and reimplantation. Otol Neurotol 2013;34:1670–4CrossRefGoogle ScholarPubMed
14Alexander, NS, Caron, E, Woolley, AL. Fixation methods in pediatric cochlear implants: retrospective review of an evolution of 3 techniques. Otolaryngol Head Neck Surg 2011;144:427–30Google Scholar
15Sweeney, AD, Carlson, ML, Valenzuela, CV, Wanna, GB, Rivas, A, Bennett, ML et al. 228 cases of cochlear implant receiver-stimulator placement in a tight subperiosteal pocket without fixation. Otolaryngol Head Neck Surg 2015;152:712–17CrossRefGoogle Scholar