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

TitleRadial Forearm Free Flap for Cochlear Implant Coverage in a Post-Irradiated Field.
Publication TypeJournal Article
Year of Publication2020
AuthorsDewyer NA, Sethi RK, Yamasaki A, Lee DJ
JournalOtol Neurotol
Date Published2020 Feb
KeywordsCochlear Implantation, Cochlear Implants, Female, Forearm, Free Tissue Flaps, Humans, Reconstructive Surgical Procedures

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.

Alternate JournalOtol Neurotol
PubMed ID31923157
Faculty Reference: 
Nicholas Dewyer, MD