Cochlear Implant Infections and Outcomes: Experience From a Single Large Center

OBJECTIVE To review our experience with cochlear implant infections over the past 5 years, the management strategy and to identify predictive factors that led to explantation. STUDY DESIGN Retrospective record-base case series of cochlear implant infections. SETTING Tertiary otology and implant center. PATIENTS All patients who had cochlear implantation over a period of 5 years. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) To identify risk factors, rates and outcomes of cochlear implant infections, and to formulate strategies to develop clearer management protocols to prevent cochlear implant explantation. RESULTS Of 704 implanted patients, 22 suffered a postoperative soft tissue infection (3%). Fifty-nine percent of these infected patients resulted in explantation, giving an explantation rate of 1.8% over the whole study population. One hundred percent of the infected implants identified as having either Staph. Aureus or Pseudomonas spp. as the single causative organism resulted in explantation. CONCLUSIONS There is a high rate of explantation when infection is detected. Currently there is no clear consensus on medical management, such as choice of antibiotics or length of antibiotic course. A registry of cochlear implants would facilitate standard reporting methods for severity and type of infection, to be able to pool data across centers and form a more robust management protocol for cochlear implant infections.