Device Fixation in Cochlear Implant Surgery: Bone Well vs. Subperiosteal Muscle Pocket Technique

Raquel A. Lauria, Gisele M. Truzzi, Alexandre Caixeta Guimarães, Sílvia Badur Curi, Arthut M. Castilho, Jorge Rizzato Paschoal, Walter Adriano Bianchini, Guilherme Machado de Carvalho^*

Otology, Audiology and Implantable Ear Prostheses Ear, Nose, Throat and Head & Neck Surgery Department, Campinas University, São Paulo, Brazil.

DOI: 10.4236/oalib.1102177                

Abstract

Introduction: Cochlear implantation (CI) is a worldwide procedure that provides hearing rehabilitation and improves speech perception. One of the described complications is the device migration, which can result of failure of receiver-stimulator (R/S) fixation. This study aims to describe the outcomes of cochlear implant receiver-stimulator (RS) placement (bone well and the subperiosteral temporal pocket technique without fixation). Methods: A retrospective case review is developed in tertiary care university hospital center that compares the bone well and the subperiosteral temporal pocket technique without fixation in two periods (at the end of the surgery and one year after CI surgery). Results: The age range from 22 to 64 years (average of 41.2 year-old). Follow-up time ranges from 12 to 51 months (average 24 months). The patients, divided into two groups (subperiostal pocket = 6 patients and bone well = 3 patients), are analyzed through major and minor complications. No intraoperative wounds or intracranial complications have been observed in either group. Device migration occurs in three patients of subperiostal pocket group (50%), but with no apparent clinical outcomes. The migration measure is about not more than 1 up to 2 centimeters antero-inferiorly by the radiography evaluation. Conclusion: Device migration is more frequent in the subperioteal pocket group (50%) with statistical significance (p < 0.05). However it is not identified, apparently, no clinical and aesthetic account related to this situation.

Keywords

Cochlear Implant, Cochlear Implants Complications, Hearing Loss, Device Migration

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Deafness and Hearing loss. World Health Organization. www.who.int/mediacentre/factsheets/fs300/en
[2]	Budenz, C.L., Cosetti, M.K., Coelho, D.H., Birenbaum, B., Babb, J., Waltzman, S.B. and Roehm, P.C. (2011) The Effects of Cochlear Implantation on Speech Perception in Older Adults. Journal of the American Geriatrics Society, 59, 446-453. http://dx.doi.org/10.1111/j.1532-5415.2010.03310.x
[3]	Pauna, H.F., Carvalho, G.M., Guimarães, A.C., Schuch, L.H., Muranaka, E.B., Bianchini, W.A., Crespo, A.N., Sartorato, E.L. and Castilho, A.M. (2014) Advanced Bionics® Cochlear Implants in Patients with Prelingual Hearing Loss. Otolaryngology, 4, 159.
[4]	Sweeney, A.D., Carlson, M.L., Valenzuela, C.V., Wanna, G.B., Rivas, A., Bennett, M.L. and Haynes, D.S. (2015) 228 Cases of Cochlear Implant Receiver-Stimulator Placement in a Tight Subperiosteal Pocket without Fixation. Otolaryngology—Head and Neck Surgery, 152, 712-717. http://dx.doi.org/10.1177/0194599814567111
[5]	Gheorghe, D.C. and Zamfir-Chiru-Anton, A. (2015) Complications in Cochlear Implant Surgery. Journal of Medicine and Life, 8, 329-332.
[6]	Guimarães, A.C., Carvalho, G.M., Duarte, A.S., Bianchini, W.A., Sarasty, A.B., Gregorio, M.F., Zernotti, M.E., Sartorato, E.L. and Castilho, A.M. (2015) Hearing Preservation and Cochlear Implants According to Inner Ear Approach: Multicentric Evaluation. Brazilian Journal of Otorhinolaryngology, 81, 190-196. http://dx.doi.org/10.1016/j.bjorl.2014.12.002