NDLI: Delayed Extradural CSF Collection Following Pediatric Cochlear Implantation: Report of Two Cases.

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Delayed Extradural CSF Collection Following Pediatric Cochlear Implantation: Report of Two Cases.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Horton, Joshua D. Friedmann, David R. Roland, J. Thomas
Description	Author Affiliation: Horton JD ( Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York.)
Abstract	INTRODUCTION: Although rare, complications in cochlear implantation may result from surgical or technical mishaps, reaction to the foreign body, infection, or mechanical device failure. Delayed cerebrospinal fluid (CSF) leak is a rarely reported condition that may present with asymptomatic swelling over the receiver-stimulator (RS). In our practice, meticulous drilling of a bony well is important in preventing device migration and maintaining a low device profile but there is the potential for immediate or delayed complication from this technique. OBJECTIVE: We report two cases of the diagnosis and management of delayed extradural CSF collection of the RS bony well and describe its successful management. PATIENTS: Two pediatric cochlear implant patients, 10 and 17 months of age with devices from different manufacturers. INTERVENTION(S): Operative exploration and repair without device removal. MAIN OUTCOME AND RESULTS: Although the initial postoperative course was uncomplicated with both patients receiving benefit from their device, both presented at varying intervals month(s) later with swelling over the RS. There were no signs of infection but the swelling prevented use of the device. Extradural CSF collection was suspected, confirmed operatively, and repaired with complete resolution without the need for reimplantation. CONCLUSION: Delayed CSF leak may present as an asymptomatic swelling over the RS after cochlear implantation. Sterile fluid aspiration may confirm the diagnosis and management can proceed conservatively or with operative exploration and repair. Future device designs with lower profiles may facilitate device fixation while allowing for a more shallow well, further reducing the risk of this rare complication.
File Format	HTM / HTML
ISSN	15317129
Issue Number	6
Journal	Otology & Neurotology
Volume Number	37
e-ISSN	15374505
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2016-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Otolaryngology
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Sensory Systems Neurology (clinical)

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