Abstract:
Background: The subtotal petrosectomy procedure may be useful for cochlear implantation in selected patient groups. Although it is highly effective, complications can arise, which may have economic implications for the patient due to the high cost of the device. Therefore, several authors have attempted to identify the most effective concept for obliteration. Methods: We present a pilot descriptive study of application techniques for obliterating cavities after subtotal petrosectomy using a temporoparietal fascial flap (TPFF) modified with injectable platelet-rich fibrin (IPRF+) for three cochlear implant (CI) patients. Results: Our concept preserves important anatomical structures, such as the temporalis muscle, which covers the CI receiver-stimulator. Injection of IPRF+ also increases the available tissue volume for obliteration and enhances its anti-inflammatory and regenerative potential. Conclusions: To the best of our knowledge, the use of TPFF for filling the cavity has not been adopted for CI with SP and for blind sac closure. Our literature review and our experience with this small group of patients suggest that this procedure, when combined with IPRF+ injections, may reduce the risk of potential infection in the obliterated cavity, particularly when used with CI. This technique is applicable only in cases when the surgeons are convinced that the middle ear cavity is purged of cholesteatoma.
摘要:
背景:次全岩石切除术可用于选定患者组中的耳蜗植入。虽然它非常有效,可能会出现并发症,由于设备的高成本,这可能对患者产生经济影响。因此,几位作者试图找出最有效的消除概念。方法:我们对三名人工耳蜗(CI)患者使用颞顶筋膜瓣(TPFF)改良的可注射富血小板纤维蛋白(IPRF)进行了次全岩性切除术后闭孔的应用技术进行了初步描述性研究。结果:我们的概念保留了重要的解剖结构,比如颞肌,包括CI接收刺激器。IPRF+的注射还增加了用于闭塞的可用组织体积并增强其抗炎和再生潜力。结论:据我们所知,对于带SP的CI和盲囊闭合,尚未采用TPFF填充腔。我们的文献回顾和我们对这一小组患者的经验表明,这种手术,当与IPRF+注射结合使用时,可以降低闭塞腔中潜在感染的风险,特别是与CI一起使用时。此技术仅适用于外科医生确信中耳腔已清除胆脂瘤的情况。