The use of subtotal petrosectomy in cochlear implant candidates with chronic otitis media

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• 作者：Marcin Szymański ; Andre Ataide ; Thomas Linder
• 关键词：Subtotal petrosectomy ; Cochlear implants ; Chronic otitis media ; Cholesteatoma ; Complications ; Imaging
• 刊名：European Archives of Oto-Rhino-Laryngology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：273
• 期：2
• 页码：363-370
• 全文大小：853 KB
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• 作者单位：Marcin Szymański (1)
  Andre Ataide (2)
  Thomas Linder (3)
  
  1. Department of Otolaryngology, Head and Neck Surgery, Medical University of Lublin, Lublin, Poland
  2. Department of Otolaryngology, Pequeno Principe Children’s Hospital, Curitiba, Brazil
  3. Department of Otorhinolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Otorhinolaryngology
  Neurosurgery
  Head and Neck Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-4726

文摘

Cochlear implants (CI) candidates with chronic otitis media require special attention and management. The need of opening of the inner ear creates potential routes of spread of infection to subarachnoid spaces and lead to meningitis. The aim of the study was to analyse the technique and complications of subtotal petrosectomy (SP) in cochlear implant candidates with chronic otitis media at three different CI centres. A retrospective study was carried out in three Territory Referral Hospitals. The centres follow Fisch’s philosophy and surgical techniques of SP. The study group consisted of 19 patients, 4 men and 15 women, aged 12–82 years. All patients underwent SP with either primary or staged CI implantation. Indications for single or a staged management, difficulties during surgery and complications were analysed. Skin and muscle flap design in primary and revision cases as well as imaging follow-up strategy are discussed. In 14 patients implantation was performed in a single stage and in 5 cases in two stages. Follow-up ranged from 8 months to 10 years. All the patients use their implants and there were no major nor minor complications. The use of subtotal petrosectomy with cochlear implants is a safe and efficient technique when strict surgical steps and rules are applied. Closure of the external ear canal after previous meatoplasty can be challenging and extreme care dissecting the skin flaps is required. In patients with extensive cholesteatoma, active discharge from the ear with resistant bacteria or an “unstable” situation, the procedure can be staged. Keywords Subtotal petrosectomy Cochlear implants Chronic otitis media Cholesteatoma Complications Imaging