title: The outcome of our modified double-flap technique for cochlear implantation: a case series of 342 consecutive patients.
abstract: OBJECTIVE
  A lazy S-shaped postauricular incision with a modified double-flap technique has been used for cochlear implant surgery at our institution for the past 10 years. The postoperative surgical complications, morbidity, and outcome of this technique were evaluated.
  
  
  METHODS
  A retrospective case review was conducted in a tertiary referral teaching center. A total of 342 patients with profound sensory hearing loss (173 female and 169 male subjects; age range, 11 months to 52 years) who underwent cochlear implantation using the double-flap postauricular transmastoid surgical approach during a 5-year period (2005 through 2009) with at least 5 years' follow-up were retrospectively evaluated. Postoperative wound complications were identified. Major complications included flap necrosis, wound infection requiring surgical intervention, and wound dehiscence with or without implant exposure. Swelling over the implant and superficial wound infections treated medically were considered minor complications. Other non-wound-related complications, surgical time, and number of electrodes inserted were also recorded.
  
  
  RESULTS
  The surgical approach was accomplished in all the patients with four minor wound complications. The mean surgical time was 1.4 hours, and the mean time between surgery and the programming process was 2 weeks.
  
  
  CONCLUSIONS
  This modified double-flap technique was easy to perform and appeared to reduce the incidence of wound complications in cochlear implant surgery. It allowed programming of the implant after a shorter period of time.
authors.forename: Firas
authors.initials: F
authors.lastname: Alzoubi
authors.forename: Haitham
authors.initials: H
authors.lastname: Odat
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al Omari
authors.forename: Bassam
authors.initials: B
authors.lastname: Al-Zuraiqi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects* / Q000379:methods*; D003054:Cochlear Implants; D012048:Correction of Hearing Impairment / Q000379:methods; D054644:Ear Auricle / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis / Q000453:epidemiology / Q000209:etiology; D061646:Operative Time; D012189:Retrospective Studies; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cochlear implants; Skin flap design; Surgical complications