228 Cases of Cochlear Implant Receiver-Stimulator Placement in a Tight Subperiosteal Pocket without Fixation. (April 2015)

• Record Type: Journal Article
• Authors: Sweeney, Alex D.; Carlson, Matthew L.; Valenzuela, Carla V.; Wanna, George B.; Rivas, Alejandro; Bennett, Marc L.; Haynes, David S.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 152:Number 4(2015:Apr.)
• Page Start: 712
• Page End: 717
• Publication Date: 2015-04
• Subjects: cochlear implant -- sensorineural hearing loss -- tight pocket -- subperiosteal pocket -- surgical technique; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814567111
• Languages: English
• ISSNs: 0194-5998

Abstract

Objectives: (1) To investigate the outcomes of cochlear implant receiver-stimulator (RS) placement using a tight subperiosteal pocket technique without device fixation and (2) to compare the efficiency of this approach with the traditional bony well and trough technique. Study Design: Case series with planned chart review. Setting: Single tertiary academic referral center. Subjects and Methods: All cochlear implant surgeries utilizing a tight subperiosteal pocket without additional fixation or use of a bone well were identified retrospectively. Revision cases were only included if the tight subperiosteal pocket technique was used during the initial surgery. Patients with less than 6 months of postoperative follow-up were excluded. Primary outcome measures included RS migration, flap complications, device failure, and percentage reduction in operative time. Results: Two hundred twenty-eight cases (average age 45.3 years) met inclusion criterion and were analyzed. At a mean follow-up of 18.1 months, no patient experienced RS migration. One patient experienced a postoperative hematoma that was managed with observation. One patient developed a surgical site infection that resolved following exploration and intravenous antibiotics. The subperiosteal pocket technique resulted in an 18.9% reduction in total operative time compared to a more conventional RS placement method ( P < .01). Conclusions: The tight subperiosteal pocket without fixation is a safe, durable, and time-saving technique for RS placement during cochlear implantation. Notably, device migration and flap complications are very uncommon.