Reliability of CIR-S using the subperiosteal pocket technique under 2 years of age

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Biomedical Engineering

Background:

• Cochlear implantation is a critical intervention for hearing loss in young children.
• Ensuring reliable placement of the cochlear implant receiver-stimulator (CIR-S) is crucial for optimal device function and patient outcomes.
• Understanding postoperative soft tissue changes around the CIR-S in toddlers is essential for long-term device integrity.

Purpose of the Study:

• To evaluate the reliability of the unfixed subperiosteal tight pocket technique for CIR-S placement in toddlers under 2 years.
• To investigate postoperative soft tissue modifications occurring around the CIR-S in this pediatric population.

Main Methods:

• A cohort of nonsyndromic toddlers (12-24 months) with normal radiological findings undergoing cochlear implantation were included.
• Objective methods were employed to analyze preoperative and postoperative complications, device migration, and soft tissue changes around the CIR-S.

Main Results:

• Twenty-six toddlers were followed for a mean of 18 months.
• No intraoperative or postoperative surgical complications were reported.
• No instances of device migration were observed in any participant.

Conclusions:

• The subperiosteal pocket technique for CIR-S placement is a reliable method in toddlers under 2 years.
• Meticulous surgical execution, including a small incision and tight pocket without fixation or excessive well drilling, is key.
• The tissues surrounding the CIR-S exhibit protective changes over time, adapting to the device and accommodating skull development.