Complications of hydroxyapatite bone cement use in cochlear implantation?

Abstract

Objective and importance

To highlight the complications of using hydroxyapatite (HA) bone cement when implanting a cochlear implant (CI) device.

Clinical presentation

A case series of three patients who had undergone cochlear implantation are presented. A bony defect was seen in the external auditory meatal wall posteriorly in all three cases. This was intimately related to the site of HA bone cement, which had been used to anchor the electrode array at the time of the original implantation. Persistent otorrhoea was usually a feature at clinical presentation.

Intervention (and technique)

Removal of the HA bone cement and repair of the bony defect has resulted in resolution of the otorrhoea and a functioning CI is present in all cases without further complications.

Conclusion

The use of HA bone cement in cochlear implantation may cause dehiscence of the external auditory meatal wall. Our experience has shown that the electrode array does not need to be secured with cement. It is therefore recommended by this centre that HA cement should not be used to secure the electrode array in cochlear implantation surgery.

Keywords:

• Cochlear implant
• Hydroxyapatite
• Otorrhoea
• Complication
• Bony defect

Acknowledgement

The co-authors have not been in receipt of any grants or funding in producing this case series.