Hematoma in the receiver area is one of the minor complications after cochlear implant (CI) surgery. While hematomas occurring several years after CI surgery are quite rare, they can cause infection and thickening of the subcutaneous tissue around the receiver area, interfering with proper functioning of the device. Therefore, prompt diagnosis and appropriate treatment are necessary.
Herein, we report the case of a 74-year-old man who was diagnosed as having delayed onset hematoma in the receiver area 5 years after CI. The patient presented to our hospital complaining of a swelling around the receiver area and increasing difficulty in using the cochlear implant. He was receiving antithrombotic drug therapy for atrial fibrillation. CT revealed a fluid collection between the subcutaneous tissue and the receiver. Needle aspiration revealed that the fluid collection was a hematoma. Although aspiration resulted in transient resolution, the hematoma recurred. Then, the antithrombotic drug was discontinued to improve the prolonged PT-INR, surgery was performed to drain the hematoma. We made a minimal skin incision just above the receiver, fearing that a large skin incision around the receiver could damage the array from the receiver and cause much bleeding during surgery leading to regrowth of the hematoma. After the treatment, the hematoma was reduced to a significantly resorbed state, enabling the patient to use the CI again.
In the future, the incidence of delayed onset hematoma after CI may increase as the number of long-term/elder CI users receiving antithrombotic therapy for other underlying conditions increases. Hence, it is crucial to resolve predisposing factors and try minimally invasive intervention at first to drain the hematoma and allow the functioning of the CI to be maintained.
