Implantable Audiologic devices and Facial Plastic Surgery in elderly patients.

Abstract

[eng] Introduction: The goal of this paper is to describe a previously unreported etiology for audiologic implant extrusion. It is necessary to place the implant closer to the cochlea for the correct conduction of the sound. This paper represents the first reported case of audiologic device extrusion secondary to previous rhytidectomy. Material and Methods: We present a case report of a 69-year-old patient with a history of rhytidectomy for aesthetic reasons 15 years ago. He was underwent transcutaneous active osseointegrated insertion, approximately 5 months later developed a 2 cm post-auricular soft tissue necrosis and partial extrusion. It was required a surgical intervention to solve the problem. Results: Exposure of otological implants requires medical/surgical intervention with antibiotic therapy, with or without replacement of such devices as well as the realization of rotational flaps to cover the skin defects. Conclusion: Previous periauricular surgery such as a parotidectomy or a rhytidectomy should be considered when select a patient to implant an otological device. In the case of osseointegrated implants, the percutaneous device could cause more skin problems than the transcutaneous one, which would lead us to choose one over another. In case of cochlear implants, should be located more posterior, away from the conflicting retroauricular area. Obviously as older as our patients get, higher are the chances to suffer those kind of complications. This complication has not been described previously, and should be analyzed in the preoperatory time in order to avoid bad results.