Infectious complications of pediatric cochlear implants are highly influenced by otitis media. (June 2017)

• Record Type: Journal Article
• Authors: Vila, Peter M.; Ghogomu, Nsangou T.; Odom-John, Audrey R.; Hullar, Timothy E.; Hirose, Keiko
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 97(2017:Jun.)
• Page Start: 76
• Page End: 82
• Publication Date: 2017-06
• Subjects: Cochlear implant -- Otitis media -- Acute otitis media -- Infectious complications -- Tube otorrhea -- Meningitis; CI cochlear implant -- OM otitis media -- MSSA methicillin sensitive staphylococcus aureus -- MRSA methicillin-resistant Staphylococcus aureus -- S. aureus Staphylococcus aureus -- AOM acute otitis media; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2017.02.026
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Objective: Determine the incidence of ear infections in cochlear implant patients, evaluate the contribution of otitis media to complications, describe the bacteriology of otitis media in the cochlear implant population, the treatment provided at our center, and the long term outcome. Methods: Data collected included age at implantation, history of otitis media or ear tubes, etiology of hearing loss, inner ear anatomy, postoperative infections, time to infection, route of antibiotic administration, and interventions for infections. Categories of infection were acute otitis media, otitis media with effusion, tube otorrhea, meningitis, scalp cellulitis, and infection at the implant site. Results: Middle ear infections were diagnosed in 37% of implanted ears. Extension of middle ear infections into the implant site occurred in 2.8% of all implants (n = 16). Of the 16 infected devices, 10 were successfully treated with antibiotic therapy and did not require explantation. The retained implant group and explanted group both included some middle ear microbes such as Haemophilus influenzae and Streptococcus pneumoniae, as well as skin flora such as Staphylococcus aureus . Conclusion: Otitis media in pediatric cochlear implant patients is a common event and usually does not lead to complications of the cochlear implant. However, when the ear infection spreads to the scalp and the implant site, it is still possible to eliminate the infection using antibiotic therapy, particularly when treatment is directed to the specific organism that is recovered from the infected space and the duration and route of antibiotic treatment is carefully considered.