{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T02:00:09Z","timestamp":1781316009310,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":67,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>When medical management fails to solve skin flap complications following cochlear implantation (CI), same\u2010sided reimplantation may be attempted using revision flaps that provide viable, vascularized tissue. This systematic review assesses long\u2010term outcomes and complications of the most prevalent skin flaps in revision CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Web of Science, and Embase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Following the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses protocol, each database was queried from inception to December 15, 2024 for articles describing revision CI after skin flap failure. A qualitative synthesis of postoperative complications and long\u2010term outcomes was employed for selected studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of an initial 1878 abstracts screened, 12 studies met the inclusion criteria, amounting to 69 flap revisions following CI. Thirty\u2010four revisions were performed after wound breakdown or skin necrosis at the implant site. Among the 7 studies that reported initial incision shape for their cohort, 5 used C\u2010shaped, 1 used inverted U, and 1 used lazy S. Of the 11 articles that described their revision flap technique, 8 used a rotational flap. Three of these studies also used temporoparietal fascia flaps (TPFF). There were 9 revision flap failures (13.4%). Successful techniques included the rotational flap with either TPFF or free flap supplementation when required for coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The current data shows that skin flap revision for CI reimplantation is a feasible option following original flap failure; however, surgeons should take care to plan appropriately for each patient's unique anatomy and available viable tissue.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oto2.70182","type":"journal-article","created":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T17:06:18Z","timestamp":1765127178000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Revision Flap Coverage Following Primary Cochlear Implant Flap Failure: A Systematic Review"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4386-4347","authenticated-orcid":false,"given":"Alexa N.","family":"Pearce","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Eckard","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaina D.","family":"Baggett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carissa 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