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Introduction. they happen! almost always preventable attention to detail early identification and management are key. Soft Tissue Complications. Soft Tissue Complications (<1yr). Soft Tissue Complications. “antecedent trauma” device movement IV antibiotics
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Introduction • they happen! • almost always preventable • attention to detail • early identification and management are key
Soft Tissue Complications • “antecedent trauma” • device movement • IV antibiotics • emergent debridement and resiting
Device Failure • 971 devices in 738 children (5575 implant-yrs) • 971 devices in 738 children (5575 implant-yrs) (3.6%)
Mastoiditis After CI • increased risk • device contamination • chronic infection • meningitis
Discussion • recent mastoidectomy may facilitate post-auricular abscess formation • IV antibiotics • early operative drainage • rapid resolution • preservation of CI
Otitis Media - Atelectasis • 2.5 yr old • 18 months post implant
Tympanic Membrane Perforation • repair • cartilage graft
Post Implantation Cholesteatoma • >2 years post-operatively • avoid breaching annulus • betadine in the canal at OR
Management of Cholesteatoma in Implanted Patients • explant and implant other side • combined approach mastoidectomies
Magnet Site Infection • common • remove magnet for a week • reapply when skin healthy with reduction in magnet force • moleskin on antenna
Facial Nerve Injury • use a monitor • damage most likely during the cochleostomy • cool if shaft touches posterior wall • decompress if injury suspected
Intracranial Bleed • rare • extradural vessel • pulsatile pain • photophobia • excessive nausea • shift of the midline?
Summary • commonest complication is device failure • most complications are easily managed • early identification is the key to successful management