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Revision Flap Coverage Following Primary Cochlear Implant Flap Failure: A Systematic Review
Alexa N Pearce1, Peter Eckard1, Alaina D Baggett1
1Department of Otolaryngology-Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA.
OTO Open
|December 9, 2025
Summary
Revision skin flaps for cochlear implantation (CI) reimplantation are feasible after initial flap failure. Rotational flaps, often with temporoparietal fascia flaps (TPFF), show success, but careful surgical planning is crucial.
Area of Science:
- Otolaryngology
- Plastic Surgery
- Regenerative Medicine
Background:
- Skin flap complications after cochlear implantation (CI) can necessitate revision surgery.
- Same-sided reimplantation using revision flaps offers a solution for viable tissue reconstruction.
Purpose of the Study:
- To systematically review long-term outcomes and complications of prevalent skin flaps used in revision cochlear implantation.
- To assess the efficacy of different flap techniques in managing CI-related skin flap failures.
Main Methods:
- A systematic review of PubMed, Web of Science, and Embase databases was conducted.
- Studies describing revision CI after skin flap failure were included, with data qualitatively synthesized.
- The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol.
Main Results:
- Twelve studies involving 69 revision flap procedures were analyzed.
- Rotational flaps, sometimes augmented with temporoparietal fascia flaps (TPFF) or free flaps, were frequently successful.
- Revision flap failure occurred in 13.4% of cases, with rotational flaps demonstrating successful outcomes.
Conclusions:
- Skin flap revision for CI reimplantation is a viable option after initial flap failure.
- Successful techniques often involve rotational flaps with TPFF or free flap supplementation.
- Individualized surgical planning considering patient anatomy and tissue availability is essential for optimal outcomes.
