Abstract
Objectives:
(1) Investigate the results of cochlear implant receiver-stimulator (RS) placement using the tight postauricular subperiosteal pocket technique. (2) Compare the efficiency of solely using a tight subperiosteal pocket compared to the conventional bone-recess technique.
Methods:
Retrospective series from a tertiary academic referral center. All primary and revision cochlear implant patients in whom the RS was placed into a tight subperiosteal pocket without additional fixation were included. Primary outcome measures included RS migration, prevalence of flap complications requiring revision surgery, and time difference comparing the conventional bony well and trough technique to use of a tight subperiosteal pocket.
Results:
Two hundred consecutive cochlear implants (average age 46.9 years) were analyzed. At a mean follow-up of 12.8 months, only 1 patient experienced device migration; however, none have required revision to date for complications related to RS placement. One patient experienced a hematoma that was managed with observation, and no other soft-tissue flap complications occurred. The subperiosteal pocket technique resulted in a 20% reduction in total operative time compared to conventional RS placement methods (P < .01).
Conclusions:
The tight subperiosteal pocket is a safe, durable, and time saving technique for RS placement during cochlear implantation. Notably, the prevalence of device migration was exceedingly low, and none have required revision surgery for device drift or flap complications to date.
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