Temporal Scalp Thickness, Body Mass Index, and Suprafascial Placement of Receiver Coil of the Cochlear Implant

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The objectives of this study are to demonstrate the relationship between the thickness of the temporal scalp and body mass index (BMI), age, and sex, and to present the surgical technique which we perform in patients with a thick scalp.

Materials and Methods:

This is a retrospective, cross-sectional study. This study was performed in a tertiary referral center. Cranial computed tomography images of 469 subjects were included in the study. These subjects were evaluated according to BMI, age, and sex. These individuals were divided into 6 groups based on the BMI levels. Differences between the groups were compared in terms of temporal scalp thickness. In 5 patients with a mean scalp thickness of 9.7 mm, the receiver coil was placed over the temporal muscle fascia through a transmuscular incision without surgical thinning of the skin flap.


Average scalp thickness was measured as significantly higher in males than in females, with advancing age, and increasing levels of BMI. In 5 adult patients with a scalp thickness measured as ≥7 mm who underwent cochlear implantation, suprafacial placement of the receiver coil achieved successful surgical and audiological results.


Thinning of the skin flap is recommended in patients with a scalp thickness ≥ 7 mm to provide effective transmission, minimalized power requirement, and magnet retention. Suprafascial placement of the receiver coil can be recommended in patients with a thick scalp without any excisional thinning impairing integrity and vascularity of the skin.

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