{"title":"414例连续人工耳蜗植入技术及并发症的临床分析","authors":"Kavitha Gauthaman, Manoj Mp","doi":"10.52314/kjent.2022.v1i1.4","DOIUrl":null,"url":null,"abstract":"Aim: To report the frequency of surgical complications following 414 consecutive cochlear implant surgeries (402 children; 12 adults), of whom 323 underwent standard incision and 91 minimal access incision and to analyze the feasibility of using the minimal access ap-proach in all CI candidates. A careful assessment was performed to analyze whether the latter approach is more advantageous than the former in different quality parameters. Methods: Retrospective analysis of patients who underwent cochlear implant surgery from February 2012 to February 2019 by the same surgeon at a single center. Patients: 414 consecutively implanted patients (male: 51.33% female: 49.33%, Right: 68.66% Left: 26.66%, Bilateral: 4.66%).323 underwent a standard incision (Lazy S) and 91 underwent a minimal access incision. The average age of the standard incision group was 4.3years (range 9months-73years); that of the minimal access group 8.6 years (Range 9months-64years). The average incision size in the standard incision group was 7.61 cm and that of the minimum access group was 4.53cm. Results: Of the 414 patients who underwent surgery there were 30 surgery related complications (12 major, 18 minor), 11 device related complications. Major complications (5.3%) included wound infection (3); device extrusion (1); electrode displacement (2); temporary CSF leak (5) (in patients with cochleovestibular dysplasia’s); magnet displacement (1). The minor complications included transient fa-cial paresis (3); vertigo (2); seroma (9); hematoma (1); tinnitus (3). There were 11 device failures, one secondary to trauma the overall complication rate (9.6%) was low in our center when compared against available literature The mean operative time was 76 minutes for standard incision and 79.5minutes for the minimal access approach. A counter sink well for the receiver stimulator array was created and tie down of the device was done in all patients irrespective of the incision, except when a thin implant was used. Clinical Significance: Cochlear implantation is a low-risk procedure when performed by an experienced surgeon following standard protocol. Detailed preoperative workup, study of access and tailoring of the approach to suit each patient is a necessity to prevent com-plications. The minimal access incision causes less morbidity, is cosmetically more acceptable to patients and offers sufficient access to perform a cochlear implantation without compromising on vital steps.","PeriodicalId":331372,"journal":{"name":"KERALA JOURNAL OF ENT AND HEAD & NECK SURGERY","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Analysis of Techniques and Complications in 414 Consecutive Cochlear Implantations\",\"authors\":\"Kavitha Gauthaman, Manoj Mp\",\"doi\":\"10.52314/kjent.2022.v1i1.4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: To report the frequency of surgical complications following 414 consecutive cochlear implant surgeries (402 children; 12 adults), of whom 323 underwent standard incision and 91 minimal access incision and to analyze the feasibility of using the minimal access ap-proach in all CI candidates. A careful assessment was performed to analyze whether the latter approach is more advantageous than the former in different quality parameters. Methods: Retrospective analysis of patients who underwent cochlear implant surgery from February 2012 to February 2019 by the same surgeon at a single center. Patients: 414 consecutively implanted patients (male: 51.33% female: 49.33%, Right: 68.66% Left: 26.66%, Bilateral: 4.66%).323 underwent a standard incision (Lazy S) and 91 underwent a minimal access incision. The average age of the standard incision group was 4.3years (range 9months-73years); that of the minimal access group 8.6 years (Range 9months-64years). The average incision size in the standard incision group was 7.61 cm and that of the minimum access group was 4.53cm. Results: Of the 414 patients who underwent surgery there were 30 surgery related complications (12 major, 18 minor), 11 device related complications. Major complications (5.3%) included wound infection (3); device extrusion (1); electrode displacement (2); temporary CSF leak (5) (in patients with cochleovestibular dysplasia’s); magnet displacement (1). The minor complications included transient fa-cial paresis (3); vertigo (2); seroma (9); hematoma (1); tinnitus (3). There were 11 device failures, one secondary to trauma the overall complication rate (9.6%) was low in our center when compared against available literature The mean operative time was 76 minutes for standard incision and 79.5minutes for the minimal access approach. A counter sink well for the receiver stimulator array was created and tie down of the device was done in all patients irrespective of the incision, except when a thin implant was used. Clinical Significance: Cochlear implantation is a low-risk procedure when performed by an experienced surgeon following standard protocol. Detailed preoperative workup, study of access and tailoring of the approach to suit each patient is a necessity to prevent com-plications. The minimal access incision causes less morbidity, is cosmetically more acceptable to patients and offers sufficient access to perform a cochlear implantation without compromising on vital steps.\",\"PeriodicalId\":331372,\"journal\":{\"name\":\"KERALA JOURNAL OF ENT AND HEAD & NECK SURGERY\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1900-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"KERALA JOURNAL OF ENT AND HEAD & NECK SURGERY\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.52314/kjent.2022.v1i1.4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"KERALA JOURNAL OF ENT AND HEAD & NECK SURGERY","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.52314/kjent.2022.v1i1.4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Clinical Analysis of Techniques and Complications in 414 Consecutive Cochlear Implantations
Aim: To report the frequency of surgical complications following 414 consecutive cochlear implant surgeries (402 children; 12 adults), of whom 323 underwent standard incision and 91 minimal access incision and to analyze the feasibility of using the minimal access ap-proach in all CI candidates. A careful assessment was performed to analyze whether the latter approach is more advantageous than the former in different quality parameters. Methods: Retrospective analysis of patients who underwent cochlear implant surgery from February 2012 to February 2019 by the same surgeon at a single center. Patients: 414 consecutively implanted patients (male: 51.33% female: 49.33%, Right: 68.66% Left: 26.66%, Bilateral: 4.66%).323 underwent a standard incision (Lazy S) and 91 underwent a minimal access incision. The average age of the standard incision group was 4.3years (range 9months-73years); that of the minimal access group 8.6 years (Range 9months-64years). The average incision size in the standard incision group was 7.61 cm and that of the minimum access group was 4.53cm. Results: Of the 414 patients who underwent surgery there were 30 surgery related complications (12 major, 18 minor), 11 device related complications. Major complications (5.3%) included wound infection (3); device extrusion (1); electrode displacement (2); temporary CSF leak (5) (in patients with cochleovestibular dysplasia’s); magnet displacement (1). The minor complications included transient fa-cial paresis (3); vertigo (2); seroma (9); hematoma (1); tinnitus (3). There were 11 device failures, one secondary to trauma the overall complication rate (9.6%) was low in our center when compared against available literature The mean operative time was 76 minutes for standard incision and 79.5minutes for the minimal access approach. A counter sink well for the receiver stimulator array was created and tie down of the device was done in all patients irrespective of the incision, except when a thin implant was used. Clinical Significance: Cochlear implantation is a low-risk procedure when performed by an experienced surgeon following standard protocol. Detailed preoperative workup, study of access and tailoring of the approach to suit each patient is a necessity to prevent com-plications. The minimal access incision causes less morbidity, is cosmetically more acceptable to patients and offers sufficient access to perform a cochlear implantation without compromising on vital steps.