Small postaural incision for paediatric cochlear implantation

Abstract

Objective: Cochlear implantation is now a well-accepted procedure in the paediatric population. The objective of this study was to evaluate the use of small postaural incision for cochlear implantation in children.

Methods: This study is a retrospective review of patients who had cochlear implantation using small postaural incision. Patient records of 34 patients who were implanted using this incision are reviewed. The technique involves drilling the bony well for the implant inside a small subperiosteal pocket standing opposite the operated ear. The rest of the steps were the same as for standard cochlear implantation.

Results: The technique proved to be very successful in all the cases. Three patients (3/34) had complications, of which two (CSF gusher and otorrhoea) were unrelated to the incision and one patient developed a mild keloid in the incision. None of the patients developed haematomas or wound infection. The incision healed well in all the cases. The average operating time was 2.5 h (which includes trainees operating and difficult cases) which dropped to 2h when the entire operation was done by the senior surgeon. In none of the cases did the incision have to be extended for exposure. The average postoperative follow up was 18 months. Patient and parent satisfaction with the small incision was extremely high.

Conclusions: Cochlear implantation using small postaural incision approach has shown good results in this series. It has been well accepted by children, their parents and the other members of the cochlear implant team. It reduces morbidity associated with a big incision and helps in quicker recovery from the operation.