Radial Forearm Free Flap for Cochlear Implant Coverage in a Post-Irradiated Field.

OBJECTIVE: To describe a novel use of a radial forearm free flap (RFFF) for soft tissue coverage over a cochlear implant (CI) in a post-irradiated field.

PATIENTS: Single patient case report of a woman with a history of radiation therapy for brainstem astrocytoma who suffered from repeated CI extrusion despite tympanomastoid obliteration and locoregional pedicled flap soft tissue coverage.

INTERVENTION(S): Sequential bilateral, single-staged revision cochlear implantation with RFFF soft tissue coverage.

MAIN OUTCOME MEASURE(S): Postoperative wound healing complications including infection or device extrusion.

RESULTS: There have been no further issues with wound healing, infection, or device extrusion with a follow up period of 3 years on one side and 8 months on the second side. Both CIs are functioning well with the flaps being sufficiently thin to allow for the use of typical external processor magnets.

CONCLUSIONS: A RFFF can be used to provide robust soft tissue coverage over a CI in a post-irradiated field. The RFFF and CI may safely be performed in a single operation.