Evaluation of Skin Scars Following Cochlear Implant Surgery

Abstract

INTRODUCTION The main goal of cochlear implantation is, without any doubt, to restore a better understanding of spoken language and thus improve the patients’ quality of life [1]. In the last years, a growing number of cochlear implant surgeons have focused on establishing minimally invasive techniques: besides atraumatic electrode insertion to spare residual hearing capabilities of the cochlea, different skin incisions were chosen with the wish for an improved aesthetic outcome and to prevent implant extrusion. Preauricular incisions were formerly performed to maximise the distance between the sutures and the implant bed, intending to reduce infections, but cannot be recommended due to the fully visible scars [2]. In retroauricular incisions, the course of the superficial temporal artery and the branches of the posterior auricular artery should be considered (Figure 1). While large incisions extending to the temporal squama were quite common in the past; nowadays many surgeons have had good experiences with rather small retroauricular incisions [3-6]. Scar outcome measures are important for patients and clinicians, since not only the long-term aesthetic impairment can be estimated, but long-term outcomes of the surgical techniques and postoperative complications like wound infections are also reflected.