Outcome of small minimal incision technique & posteriorly based periosteal flap with subcutaneous closure in cochlear implant surgery

Abstract

Background: Although cortical mastoidectomy and posterior tympanotomy has not changed for more than 40 years, the major changes are in the skin flap incision and implant technique in CI surgery. Regarding the incision technique the smaller the incision with less soft tissue manipulation the best. Post-operative healing and scar result also small incision have adequate blood supply and venous drainage, graft has good exposure and coverage of the PP field. There are different types of incisions and flaps which are used by different surgeons around the world for cochlear implant surgery. In this study 3 types of incisions and flaps were used, Small incision for cochlear implant surgery reduce the morbidity and increase parent satisfaction as compared with wider access operation incisions also will prevent the scalp flap complication, this is achieved by good flab design that should have adequate blood supply and venous drainage, enough field exposure and coverage. Methods: This is retrospective study for 145 child age ranges between (1-5)years old, underwent cochlear implant surgery with deferent companies (AB, cochlear, med el) in Al-Yarmouk Teaching Hospital/ENT department from 2014- July.2018. 3 types of incisions and flaps were used, Slight curve line post auricle incision (Small hair line post-auricle incision), Lazy S incision, Small post-auricle with superior extension, was made with posterior flap elevation was used as an axis to the mastoid cavity and the wheel for the implant device, with subcutaneous closure and without skin closure. Result: It’s found that there is early healing, no major flap complication by using Slight curve line post auricle incision (Small hair line post-auricle incision), no skin stitches are required, end with minimum or no scar, minimum time consuming and easy follow-up for the children post-operatively.