Artikel
Small incision cochlear implantation in children
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Veröffentlicht: | 19. April 2011 |
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Introduction: Small incision cochlear implant surgery in children has been advocated to reduce post-operative morbidity and have a psychological effect on parents. The objective of our paper was to compare a simple technique for implant fixation that creates a bonny well for the device and suture fixation through the cranial periosteum using a small incision with the standard technique.
Methods: Among 60 cochlear implantations in children performed with MED-EL devices between January 2003 and December 2009, there were 21 cases with very thin cortical bone in which small incision cochlear implant surgery were performed. As drill – hole fixation methods can carry the potential for dural injury we have used the suture fixation through the cranial periosteum. This method shortened the surgical time and there were no specific postoperative complications. The average follow-up of 14.4 months was uneventful with the implants well covered and fixed in their position with one exception. The results were compared with the classic technique.
Results: 21 children have been implanted with the small incision technique. One complication has occurred related to the current technique (maximum follow up 30 months). No flap necrosis, hematoma or infection, nor extrusion or breakdown was encountered with either technique. Revision surgery was performed in 2 patients (1 with small incision due to posttraumatic device failure) and one due to colesteatoma. The use of this minimally invasive surgical technique did not increase the surgical risk.
Conclusion: MED-EL device implantation can be performed using small incisions with periosteal sutures of the receiver. The described approach therefore appears to be a safe and time-effective alternative to the standard procedure.