title: Use of Pericranial Flap Coverage in Cochlear Implantation of the Radical Cavity: Rationale, Technique, and Experience.
abstract: Cochlear implant (CI) surgery in the setting of an open mastoid cavity is evolving. Two strategies are commonly pursued: a staged approach, clearing the disease, closing the meatus or the external auditory canal (EAC), and reevaluating in 3 to 6 months prior to implantation, or a single-stage procedure with mastoid obliteration without EAC closure. Meatal closure is often employed in the setting of an open mastoid cavity to reduce the risk of electrode extrusion and infection. An open cavity offers the advantages of being a single-stage procedure, permitting direct surveillance for recurrent cholesteatoma, and reducing the need for repeat computed tomography scans. We describe an approach to the coverage of a CI within a dry, open mastoid cavity using an anteriorly-based postauricular pericranial flap.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Nieman
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Weinreich
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Sharon
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Section on Sensory Cell Biology, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Wade W
authors.initials: WW
authors.lastname: Chien
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA hfrancis@jhmi.edu.
authors.forename: Howard W
authors.initials: HW
authors.lastname: Francis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation / Q000379:methods*; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D012886:Skull / Q000637:transplantation*; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: cochlear implantation; external auditory canal closure; literature review; open mastoid cavity; pericranial tissue flap; retrospective cohort series