The avoidance and treatment of scalp flap complications in cochlear implant surgery

Successful cochlear implantation produces a durable, reaction-free surgical site that allows the patient to use his/her implant system comfortably with a cosmetically acceptable appearance. The most frequently reported major and minor complications after cochlear implantation are those related to the incision and postauricular scalp flap. Ideal flap design that considers vascularity of the postauricular area, skull anatomy, device design, and proper surgical principles will prevent most complications from occurring. When complications do occur, treatment requires thoughtful and aggressive therapy to avoid further patient discomfort, morbidity, surgery, and dreaded device explantation. It cannot be stressed enough that prevention is the key.