Haematoma after cochlear implantation: management of a minor complication.
CONCLUSIONS
The dimensions of the implant receiver and the material used have influenced the surgical approach leading to a reduction in complications. Ultrasonography of the haematoma is useful in the evaluation of dimensions, entity of fluid component and therapeutic options.


OBJECTIVE
Haematoma arising in the receiver area is considered a minor complication, nevertheless it can be complicated by infection and/or flap necrosis or fibrosis leading to difficulties in magnetic adherence of the receiver and rarely to explantation of the receiver. The objective of the study was to evaluate the clinical outcome of postoperative haematoma arising after cochlear implant surgery.


METHODS
This was a retrospective case series of 22 cochlear implant patients who developed post-implant haematoma over the receiver area. Haematoma extension and fluid collection were analysed via ultrasonography, implant type and predisposing factors such as trauma, coagulation disorders and type of skin incision.


RESULTS
Patients were divided into four groups on the basis of the main predisposing factor: coagulation disorders (n=7), trauma (n=3), revision surgery (n=6) and haematoma of unknown origin (n=6). The main factors correlated to haematoma onset were coagulation disorder, type of skin incision and flap revision. In all, 21 subjects had complete recovery and the speech perception performance was not compromised over time, while 1 subject (0.3%) with an extensive haematoma due to a pharmacologically induced coagulation disorder required explantation of the device.
Filipo
Roberto
R
Dipartimento di Neurologia ed Otorinolaringoiatria, Università La Sapienza di Roma, Policlinico Umberto I, Rome, Italy. roberto.filipo@uniroma1.it
D'Elia
Chiara
C
Covelli
Edoardo
E
Bertoli
Gian Antonio
GA
De Seta
Elio
E
Manganaro
Fabio
F
Mancini
Patrizia
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D004322:Drainage / Q000379:methods; D004867:Equipment Design; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013067:Speech Perception; D014463:Ultrasonography; D055815:Young Adult