Epicutaneous patch test--a new diagnostic option to prevent the rejection of silicone-covered cochlear implants in children

Int J Pediatr Otorhinolaryngol. 2013 Oct;77(10):1635-8. doi: 10.1016/j.ijporl.2013.06.023. Epub 2013 Aug 12.

Abstract

Objectives: Cochlear implantation (CI) is a revolutionary method for hearing rehabilitation in patients with severe or profound sensorineural hearing loss. One of the surgical complications may be the necrosis of the skin flap above the receiver-stimulator coil, resulting in device extrusion. Our aim was to find the plausible causes of the silicone covered implant rejection.

Patients and methods: Authors present four cases of cochlear implant rejection, briefly describe their dermato-surgical solutions and analyse their innovative method - the epicutanoeus patch testing with silicone samples.

Results: They observed positive skin reaction in three of the four cases.

Conclusion: Authors analyse the applicability and results of their surgical solutions and the epicutaneous testing in connection with the prevention of skin flap necrosis and rejection of silicone-covered cochlear implants.

Keywords: Cochlear implantation; Epicutaneous patch test; Loco-regional skin flaps; Skin flap necrosis; Surgical complication.

MeSH terms

  • Child, Preschool
  • Cochlear Implantation / adverse effects
  • Cochlear Implantation / methods
  • Cochlear Implants*
  • Deafness / diagnosis
  • Deafness / surgery
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Hearing Loss, Sensorineural / diagnosis
  • Hearing Loss, Sensorineural / surgery
  • Humans
  • Male
  • Necrosis / pathology
  • Patch Tests / methods*
  • Prosthesis Design
  • Prosthesis Failure*
  • Risk Assessment
  • Sampling Studies
  • Silicones* / adverse effects
  • Surgical Flaps / pathology*
  • Treatment Outcome
  • Wound Healing / physiology

Substances

  • Silicones