Surgical salvage of exposed cranial neuromodulating devices resulted in a functional device without wound healing concerns at 1 year in 66.7% (4 of 6) of patients.
Observational (n=6)
No
Does surgical salvage maintain functional neuromodulating devices in patients with hardware exposure?
Surgical salvage is a viable alternative to explantation for exposed cranial neuromodulating devices, achieving a 66.7% success rate at 1 year.
OBJECTIVES: Implanted neuromodulating devices (NMDs) such as cochlear implants (CIs) and deep brain stimulators (DBSs) are commonly used in modern medicine. Rarely, complications arise post-operatively, including hardware exposure. Traditional teaching suggests that these devices require removal if exposed; however, surgical salvage is a high risk, high reward alternative. We review our single institution experience managing NMD exposure with surgical salvage. METHODS: Retrospective chart review was performed on individuals who had a NMD implanted and underwent an attempt at surgical salvage for exposure during the study period (January 01, 2021 through December 31, 2023). Study outcome success was defined as maintaining a functional NMD 1 year after salvage was attempted. Surgical techniques associated with successful salvage were compared. RESULTS: Nine of 729 patients (1.2%) implanted with NMDs experienced hardware exposure during this 2-year study period. Nine subjects were referred for NMD salvage; however, only 6 of 9 subjects (66.7%, CI = 3; DBS = 3) underwent NMD salvage attempts. Four of the subjects had successful salvage demonstrated successful salvage with a functioning NMD and without wound healing concerns 1 year after their salvage procedure. CONCLUSIONS: Classic teaching states that exposed NMDs require explantation. However, this approach necessarily imposes time without benefit from the NMD between explantation and reimplantation. Our experience demonstrates that surgical salvage can be a successful alternative for the majority (66.7%) of individuals.
Molotkova et al. (Wed,) conducted a observational in Exposed cranial neuromodulating devices (n=6). Surgical salvage was evaluated on Maintaining a functional neuromodulating device 1 year after salvage without wound healing concerns. Surgical salvage of exposed cranial neuromodulating devices resulted in a functional device without wound healing concerns at 1 year in 66.7% (4 of 6) of patients.