A novel treatment for CI extrusion with vacuum-assisted closure device

Abstract

Objective: To assess if a vacuum-assisted closure device initially utilised as a temporising measure to dress a wound defect over a cochlear implant prior to definitive surgical intervention could instead be used to close the soft tissue and avoid surgery.

Method: This is a case report describing the novel use of VAC (Vacuum-Assisted Closure Device) in the successful closure of a wound defect with cochlear implant hardware exposure post soft tissue infection during the Covid-19 pandemic.

Results: While the VAC system was initiated for temporary wound coverage, it was observed at each dressing change to be successfully decreasing the soft tissue defect for our patient. This resulted in complete epithelisation of the soft tissue defect at Day 35 and avoidance of a surgical procedure. The patient was able to restart wearing her device on Day 50 and Cochlear MAPping performed on Day 58 showed minimal changes in patient’s current requirements compared to her settings pre-infection.

Conclusion: The use of V.A.C dressing for a small soft tissue defect over an extruded cochlear implant seems promising as exemplified by our case study. However, due to the lack of literature, more studies should be done to prove its usefulness in such an application.

Keywords:

• Cochlear implants
• Cochlear implantation
• Complications
• Postoperative complications
• Necrosis
• Management
• Infection

Additional information

Notes on contributors

Celeste Ann Chua

Dr Celeste Ann Chua is a Consultant at Sengkang General Hospital with a subspecialty interest in Otology.

Jiun Fong Thong

Dr Jiun Fong Thong is a Senior Consultant at the Singapore General Hospital where she serves as Director at its Centre for Hearing and Ear Implants.

Siti Radhziah Binte Sudirman

Dr Siti Radhziah Binte Sudirman is a Head and Neck Resection and Reconstructive Surgeon at the Singapore General Hospital. Her research interests include that of Medical Device Innovation.