Minimizing wound complications in cochlear implant surgery

Objective: An extended postauricular incision has replaced the standard C-s haped scalp flap for cochlear implant surgery at our institution. The posto perative wound complication rates of the two incisions were evaluated. Study Design: This study was a retrospective case review. Setting: This study was performed in a tertiary referral center. Patients: A total of 256 adult and pediatric patients who underwent cochlea r implantation during a 10-year period (1986 to 1996) were reviewed. Main Outcome Measure: Postoperative wound complications were identified. Ma jor complications included flap necrosis, wound dehiscence with or without implant exposure, and wound infection requiring hospitalization. Hematoma, seroma, or superficial wound infections were considered minor complications . Results: There were 6 major and 6 minor complications among 116 patients wi th the standard scalp flap (complication rate, 10.3%). There was only 1 min or complication among 140 implants using the postauricular incision (0.7%). Conclusion: The extended postauricular incision appears to significantly re duce the incidence of wound complications in cochlear implant surgery.