title: Electrode array extrusion through the posterior canal wall presenting as a delayed post-cochlear implant complication.
abstract: OBJECTIVES AND IMPORTANCE: Cochlear implantation is an established, reliable, and safe procedure with a low complication rate. Electrode array extrusion through the posterior aspect of external ear canal is a potential major complication of cochlear implant surgery that may result in revision surgery or explantation. Although there have been previous case reports of such extrusions through the tympanic membrane, this is the first well-documented report of an extrusion through the posterior canal wall which was previously intact.
  
  
  METHODS
  In this case report, we present a case of electrode array extruding through an initially intact posterior canal wall presenting as a delayed post-operative complication in a 13-year old Asian boy.
  
  
  METHODS
  With reference to existing relevant literature, the case is discussed focusing on its management, possible contributing factors, and prevention strategies.
  
  
  CONCLUSIONS
  Excessive thinning of the bony wall should be avoided as it can potentially break down. Abutment on the posterior canal wall by a coiled electrode array in the mastoid cavity exerting undue pressure on the bony wall can further contribute to additional stress. The implant surgeon must be cognizant of mastoid growth patterns in children. Life-long regular follow-up in implanted patients is crucial.
authors.forename: Mahalakshmi
authors.initials: M
authors.lastname: Rangabashyam
authors.forename: Sharon Shuxian
authors.initials: SS
authors.lastname: Poh
authors.forename: Wong Kein
authors.initials: WK
authors.lastname: Low
mesh_terms: D000293:Adolescent; D019929:Cochlear Implantation / Q000009:adverse effects* / Q000379:methods; D003054:Cochlear Implants / Q000009:adverse effects*; D020878:Device Removal; D004424:Ear Canal / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D011475:Prosthesis Failure / Q000009:adverse effects*; D011859:Radiography; D012086:Reoperation
keywords: Cochlear implant; Electrode array extrusion; Mastoid growth patterns; Post-operative complication