Hyperbaric oxygen therapy as a therapeutic option in cochlear implants extrusion treatment in infected wounds

Abstract

Background: Cochlear implant extrusion as a result of infection is an uncommon, but serious complication, which can lead to implant removal as the ultimate solution.

Objectives: (1) to identify the incidence of cochlear implant extrusion and its causes, (2) to report our management of patients presenting skin complications after cochlear implant surgery (3) to propose new therapeutical options with hyperbaric oxygen therapy (HBOT).

Materials and methods: A retrospective analysis of medical documentation of 1250 patients who were operated on with cochlear implants in our department between 1993 and 2015. The medical charts of 25 patients were selected due to reported skin flap complications resulting in CI extrusion. Five of those patients were subsequently removed from the study because of no infection signs.

Results: Non-traumatic cochlear implant extrusion occurred in 1.6% of implanted patients, and secondary treatment was effective in 90% of all cases (18 of 20 patients). HBOT as additional treatment was applied in 9 patients.

Conclusions: Hyperbaric oxygen therapy can be considered as safe adjuvant treatment option in individual cases of proceeding with cochlear implant extrusion with signs of wound infection.

Significance: HBOT may contribute to reducing the need for cochlear implant explantation due to infectious skin flap complication.

Chinese abstract

背景：感染导致的人工耳蜗挤压是一种罕见但严重的并发症, 最终解决方案是移除人工耳蜗。

目的：（1）了解人工耳蜗挤压的发生率及其原因；（2）报告人工耳蜗植入术后皮肤并发症的处理；（3）提出高压氧治疗（HBOT）的新治疗方案。

材料与方法：对1250例1993年至2015年间在我科进行人工耳蜗植入手术的患者进行回顾性研究。选用了25位因皮瓣并发症导致CI挤压的患者的病历。由于没有感染迹象, 其中5名患者随后被排除。

结果：1.6%的耳蜗植入患者出现非外伤性人工耳蜗挤压, 继发治疗有效率为90%（20例中的18例）。对9例患者应用HBOT作为附加治疗。

结论：对于人工耳蜗植入术后并发伤口感染的病例, 高压氧治疗可作为个体化的安全辅助治疗方案 。

意义：HBOT可能有助于减少由于感染性皮瓣并发症而移出 人工耳蜗植入体的必要。

Keywords:

• Hyperbaric oxygen
• wound healing
• cochlear implant extrusion

Disclosure statement

No potential conflict of interest was reported by the author(s). The authors report no financial and material support for the research and the work in the manuscript. The principal investigator of the research, Pedro Clarós (M.D., Ph.D.), states that he had full access to all data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis.