Accidental Explantation of a Cochlear Implant in a Child Who Developed Cholesteatoma as a Late Complication of Cochlear Implantation.

IF 0.4 Q4 OTORHINOLARYNGOLOGY
Case Reports in Otolaryngology Pub Date : 2020-10-09 eCollection Date: 2020-01-01 DOI:10.1155/2020/6353706
Wong Kein Low, Wan Ni Pok, Win Nie Ng, Judy Tan
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引用次数: 1

Abstract

Introduction: Although rare, cholesteatoma can develop as a late complication of cochlear implantation. The electrode array may then be exposed in the external auditory canal surrounded by cholesteatoma debris. Case Report. The cochlear implant of a child was inadvertently explanted by a clinician during a routine aural toilet procedure. The child had previously reported recurrent ear infections, pain, and unexplained implant function degradation. Reimplantation was carried out 2 days later with good postoperative hearing results. Part of the electrode array was observed to be embedded in cholesteatoma. Postreimplantation recovery was complicated by a breakdown of the blind-sac. Discussion. Clinical indicators that could alert the clinician to the possibility of this late complication include recurrent infections, presence of keratotic debris in the external auditory canal, unexplained implant function degradation, and nonauditory stimulation. Although this patient managed to achieve excellent postreimplantation hearing outcomes, a delay in reimplantation surgery following explantation could possibly compromise successful reinsertion of the electrode array. External ear canal overclosure without mastoid cavity obliteration has merit in facilitating CT scan surveillance, but it may increase the risk of the blind-sac breaking down. This case also illustrated how the electrode array could have facilitated propagation of the cholesteatoma from the middle ear to the mastoid.

Conclusion: If aural toilet is required in the implanted ear of a cochlear implant recipient, any complaint of hearing change, pain, or discharge should alert the clinician of the possibility of cholesteatoma developing. It warrants prompt evaluation by an experienced otologist in order to prevent accidental explantation. Keywords. Cochlear implant, cochlear implant complications, chronic suppurative otitis media, cholesteatoma, reimplantation, blind-sac, external auditory canal overclosure, mastoid cavity obliteration.

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意外植入人工耳蜗儿童胆脂瘤作为人工耳蜗植入的晚期并发症。
简介:胆脂瘤虽罕见,但可发展为人工耳蜗植入的晚期并发症。电极阵列可以暴露在被胆脂瘤碎片包围的外耳道中。病例报告。一个孩子的人工耳蜗在一次常规的听觉厕所手术中被临床医生无意中取出。该患儿此前曾报告耳部反复感染、疼痛和不明原因的植入物功能退化。术后2 d再植,术后听力良好。观察到部分电极阵列嵌埋在胆脂瘤中。术后恢复因盲囊破裂而变得复杂。讨论。临床指标可提醒临床医生注意这种晚期并发症的可能性,包括反复感染、外耳道存在角化碎片、不明原因的植入物功能退化和非听觉刺激。尽管该患者在植入术后获得了良好的听力效果,但植入术后再植入术的延迟可能会影响电极阵列的成功再植入术。不封堵乳突腔的外耳道过闭有利于CT扫描监测,但可能增加盲囊破裂的风险。这个病例也说明了电极阵列如何促进胆脂瘤从中耳到乳突的扩散。结论:如果人工耳蜗受者的植入耳内需要使用耳屎,任何有关听力改变、疼痛或分泌物的抱怨都应提醒临床医生注意发生胆脂瘤的可能性。它保证由经验丰富的耳科医生及时评估,以防止意外外植。关键词。人工耳蜗、人工耳蜗并发症、慢性化脓性中耳炎、胆脂瘤、人工耳蜗再植、盲囊、外耳道过闭、乳突腔闭塞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Case Reports in Otolaryngology
Case Reports in Otolaryngology OTORHINOLARYNGOLOGY-
自引率
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审稿时长
13 weeks
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