Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Reconstruction of a scalp defect due to cochlear implant device extrusion using a temporoparietal fascia flap and a split-thickness skin graft from the scalp

  • Kang, Jae Kyoung (Department of Plastic and Reconstructive Surgery, Jeju National University College of Medicine) ;
  • Lee, Jae Seong (Department of Plastic and Reconstructive Surgery, Jeju National University Hospital) ;
  • Suh, Michelle (Department of Otorhinolaryngology, Jeju National University College of Medicine) ;
  • Lim, Gil Chae (Department of Otorhinolaryngology, Jeju National University College of Medicine) ;
  • Shin, Myoung Soo (Department of Plastic and Reconstructive Surgery, Jeju National University College of Medicine) ;
  • Yun, Byung Min (Department of Plastic and Reconstructive Surgery, Jeju National University College of Medicine)
  • Received : 2019.07.19
  • Accepted : 2019.09.16
  • Published : 2019.10.20
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Abstract

Cochlear implant extrusion, which is a common complication of cochlear implants, is generally repaired by a well visualized soft-tissue flap. A 61-year-old female patient with a medical history of schizophrenia who had a skin ulcer that caused cochlear implant extrusion, but that would be a stronger statement was referred to our department for removal of the implant and reconstruction of the resultant scalp defect. Accordingly, the broad defect was covered via rotation of a temporoparietal fascia flap (TPFF) using the superficial temporal artery, with the pedicle in the preauricular region as the pivot point. Coverage of TPFF was achieved with a split-thickness skin graft using the scalp as the donor site, which led to a quick recovery after the operation and satisfactory results in terms of aesthetics. This case suggests that a TPFF might be used as a flexible flap with low donor site morbidity for reconstructing cases of cochlear implant extrusion accompanied by a large full-layer scalp defect.

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References

  1. Ramos A, Charlone R, de Miguel I, Valdivielso A, Cuyas JM, Perez D, et al. Complications in cochlear implantation. Acta Otorrinolaringol Esp 2006;57:122-5. https://doi.org/10.1016/S0001-6519(06)78675-7
  2. Karimnejad K, Akhter AS, Walen SG, Mikulec AA. The temporoparietal fascia flap for coverage of cochlear reimplantation following extrusion. Int J Pediatr Otorhinolaryngol 2017;94:64-7. https://doi.org/10.1016/j.ijporl.2017.01.020
  3. Collar RM, Zopf D, Brown D, Fung K, Kim J. The versatility of the temporoparietal fascia flap in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2012;65:141-8. https://doi.org/10.1016/j.bjps.2011.05.003
  4. Beckenstein MS, Steenerson RL, Elliott LF, Hartrampf CR Jr. Use of a superficial temporal fascia flap for coverage of an exposed cochlear implant. Otolaryngol Head Neck Surg 1999;120:940-2. https://doi.org/10.1016/S0194-5998(99)70343-8
  5. Geraghty M, Fagan P, Moisidis E. Management of cochlear implant device extrusion: case series and literature review. J Laryngol Otol 2014;128 Suppl 2:S55-8. https://doi.org/10.1017/S002221511300323X
  6. Leach J, Kruger P, Roland P. Rescuing the imperiled cochlear implant: a report of four cases. Otol Neurotol 2005;26:27-33. https://doi.org/10.1097/00129492-200501000-00006
  7. Roland JT Jr, Huang TC, Cohen NL. Revision cochlear implantation. Otolaryngol Clin North Am 2006;39:833-9. https://doi.org/10.1016/j.otc.2006.04.005
  8. Leedy JE, Janis JE, Rohrich RJ. Reconstruction of acquired scalp defects: an algorithmic approach. Plast Reconstr Surg 2005;116:54e-72e. https://doi.org/10.1097/01.prs.0000179188.25019.6c
  9. Newman MI, Hanasono MM, Disa JJ, Cordeiro PG, Mehrara BJ. Scalp reconstruction: a 15-year experience. Ann Plast Surg 2004;52:501-6. https://doi.org/10.1097/01.sap.0000123346.58418.e6
  10. Eun SC, Kim SY, Kim CS, Koo JW. Temporalis myofascial flap coverage for extrusion of internal device after cochlear implantation. Int J Pediatr Otorhinolaryngol 2016;91:124-7. https://doi.org/10.1016/j.ijporl.2016.10.023
  11. Motomura H, Muraoka M, Nose K. Eyebrow reconstruction with intermediate hair from the hairline of the forehead on the pedicled temporoparietal fascial flap. Ann Plast Surg 2003;51:314-8. https://doi.org/10.1097/01.SAP.0000054246.96906.F7
  12. Yamauchi M, Yotsuyanagi T, Yamashita K, Ikeda K, Urushidate S, Mikami M. The reverse superficial temporal artery flap from the preauricular region, for the small facial defects. J Plast Reconstr Aesthet Surg 2012;65:149-55. https://doi.org/10.1016/j.bjps.2011.09.013
  13. Tenna S, Brunetti B, Aveta A, Poccia I, Persichetti P. Scalp reconstruction with superficial temporal artery island flap: clinical experience on 30 consecutive cases. J Plast Reconstr Aesthet Surg 2013;66:660-6. https://doi.org/10.1016/j.bjps.2013.01.010
  14. Sharma RK, Tuli P. Occipital artery island V-Y advancement flap for reconstruction of posterior scalp defects. J Plast Reconstr Aesthet Surg 2010;63:410-5. https://doi.org/10.1016/j.bjps.2008.12.017
  15. Crawford BS. An unusual skin donor site. Br J Plast Surg 1964;17:311-3. https://doi.org/10.1016/S0007-1226(64)80049-7
  16. Berkowitz RL. Scalp-in search of the perfect donor site. Ann Plast Surg 1981;7:126-7. https://doi.org/10.1097/00000637-198108000-00008
  17. Taylor JW, Wilmore DW, Peterson HD, Pruitt BA Jr. Scalp as a donor site. Am J Surg 1977;133:218-20. https://doi.org/10.1016/0002-9610(77)90084-8
  18. Brou J, Vu T, McCauley RL, Herndon DN, Desai MH, Rutan RL, et al. The scalp as a donor site: revisited. J Trauma 1990;30:579-81. https://doi.org/10.1097/00005373-199005000-00009