Methods for measuring pre-, intra-, and postoperative skin thickness for cochlear implants

OBJECTIVE: This study was conducted to determine whether there is a reliable method for measuring the thickness of the retroauricular skin before, during, and after cochlear implantation, which allows the assessment of the optimal force of the external magnet of the cochlear implant (CI). METHODS: The retroauricular skin thickness of 83 patients who received a CI was measured using three different methods. The thickness was measured on pre- and postoperative CT images, as well as intraoperatively. The magnet category chosen by the surgeon was recorded when the implant was switched on and during the first follow-up visit. Correlation analyses were performed on the different skin thickness measurements and between the skin thickness and magnet strength categories. RESULTS: Only six patients required an exchange of the magnet until the follow-up. Although the median absolute thickness differed significantly between the three measures (p < 0.0001), their thickness values showed highly significant correlations (Pearson's r = 0.457–0.585; p < 0.01). In addition, magnet strength, was significantly correlated with the flap thickness determined pre-, post-, and during surgery. The lowest correlation with magnet strength was found in the intraoperative needle method. CONCLUSION: All three measurements methods provided a suitable base for determining the ideal magnetic force. However, of particular interest were the pre- and postoperative CT measurements. The first enabled the early assessment of the required magnetic strength and thus a timely postoperative supply, whereas the latter helped to estimate the need for magnetic strength reduction during follow-up care and the feasibility of an early swith-on.