A systematic review on prevention and management of wound infections from cochlear implantation

Abstract

Objective of review Surgical site infections are a recognised complication of cochlear implant (CI) surgery with significant morbidity. Our aim was to search for the optimum prevention and management strategy to deal with this issue. Type of review Systematic review. Search strategy A systematic literature search was undertaken from the databases of Embase, CINAHL, MEDLINE®, Web of Science, Scopus and Cochrane Library according to the predefined inclusion and exclusion criteria. Evaluation method All relevant titles, abstracts and full‐text articles were reviewed by two authors who resolved any differences by discussion and consultation with senior authors. Results Fourteen articles were included in our review. The overall quality of evidence was low with the vast majority of the studies being retrospective case series and expert opinions. No randomised controlled trials were noted. We found consistent reports that intraoperative prophylactic antibiotics should be given to all patients undergoing CI and that the vast majority of CI wound infections had grown Staphylococcal spp. or Pseudomonas spp. Conclusion Our review has not identified any reliable or reproducible strategies to prevent and deal with wound infections after CI. We strongly encourage further research within this field and would suggest that a consensus of opinions from a multidisciplinary panel of experts may be a pragmatic way forward as an effective guide.

Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes

“…In general, perioperative complications were rare, with only 3.5% (n = 4) of cases being reported within 6 months. Considering the fact that the vast majority of patients took systemic steroids or immunosuppresants (Table 4), it is reassuring that this percentage for wound complication in AIED is not higher than that seen in overall CI cases (1‐8%) 43 . Longer‐term complications did develop as mentioned in the results section.…”

Cochlear implantation in systemic autoimmune disease

“…Postoperatively, there should be close monitoring for wound-related complications, especially if skin atrophy was evident intraoperatively. However, the overall risk of wound infection of 3.5% in this group of patients has not been found to be higher than that of the general population undergoing cochlear implantation [26 ▪ ,29]. The patient should continue follow-up and medical management of their underlying systemic autoimmune disorder with their attending rheumatologist to avoid uncontrolled disease flares which have been found to affect implant performance [30 ▪▪ ,31].…”

Preventing Biofilm Formation and Development on Ear, Nose and Throat Medical Devices

“…At its core, the operational principle has a platinum-based electrode, which stimulates the cochlear nerve and the spiral ganglion cells turning acoustic sounds into an electric signal. The position can influence the success due to the safety of the receiver-stimulator package, thus reducing trauma [108]. Some options surpass the use of solely CI, such as bimodal hearing.…”