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

Vijendren, Ananth; Ajith, Amritha; Borsetto, Daniele; Tysome, James R.; Axon, Patrick; Donnelly, Neil; Bance, Manohar

doi:10.1097/mao.0000000000002772

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…Earlier explantation in children may be driven by the need to expedite reimplantation, especially among young children where hearing is critical for speech and language development. Our findings are consistent with a prior study of 13 devices showing that the median time to explantation was approximately 7 months, 16 but they contrast with a 35‐year retrospective review of 29 devices that were explanted for CI infection, which demonstrated a median explantation time of 6.6 years. 17 This disparity may partially be explained by our study design focusing on the first 2 years after CI surgery.…”

Section: Discussionsupporting

confidence: 87%

Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

Moon¹,

Qian²,

Ahmad³

et al. 2022

Otolaryngol.--head neck surg.

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Objective To describe the natural history, detail the treatment patterns, and identify the risk factors for cochlear implant (CI) infections in a large US cohort. Study Design Retrospective study based on insurance claims. Setting Optum Data Mart database: 6101 patients who received CIs from 2003 to 2019. Methods Infections, treatments patterns, and timelines were described. A multivariable logistic regression model was used to assess the association between postoperative oral antibiotics and CI infection. Results The cohort includes 4736 (77.6%) adults and 1365 (22.4%) children. Between adult and pediatric patients, rates of CI infection (5.1% vs 4.5%, P = .18) and explantation (1.2% vs 0.8%, P = .11) were not significantly different. Infections typically occurred within 5 months of surgery. Children were diagnosed with CI infection earlier than adults (median difference, –1.5 months; P = .001). Postoperative oral antibiotic supply was not associated with lower risk of CI infection in either children or adults. However, among adults, otitis media was associated with higher odds of CI infection (odds ratio, 1.41; P < .001), while higher income was associated with lower odds of CI infection (odds ratio, 0.71; P = .03). Conclusions Postoperative oral antibiotics were not associated with lower risk of infection or interventions. Otitis media episodes and lower income were associated with increased risk of infection among adults as well as intervention overall. Infection typically presented within the first 6 months after surgery, with children presenting earlier than adults. Overall, our findings serve as a resource for providers to consider in their care of patients with CIs.

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Section: Discussionsupporting

confidence: 87%

Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

Moon¹,

Qian²,

Ahmad³

et al. 2022

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

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“…The need for explantation in the management of CI infections is uncommon with rates between 0.65% and 1.8% of CI recipients [37,[41][42][43]. Attempts initially at device salvage should be considered given favourable outcomes with this approach [14,24].…”

Section: Investigation and Management Of Cochlear Implant Associated ...mentioning

confidence: 99%

An overview of risk factors, management and prevention of cochlear implant infections

MacKay,

Kuthubutheen,

Campbell

2024

Current Opinion in Infectious Diseases

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Purpose of review With cochlear implantation becoming increasingly performed worldwide, an understanding of the risk factors, preventive measures, and management of cochlear implant (CI) infection remains important given the significant morbidity and cost it conveys. Recent findings At the turn of the 21st century there was a decrease in rates of CI infection, particularly meningitis, following the discontinuation of positioner use for CI. However, in more recent years rates of CI infection have remained largely static. Recently, studies evaluating preventive measures such as pneumococcal vaccination, S. aureus decolonization and surgical antibiotic prophylaxis have emerged in the literature. Summary Prompt recognition of CI infection and appropriate investigation and management are key, however at present treatment is largely informed by cohort and case-control studies and expert opinion. Preventive measures including pneumococcal vaccination, S. aureus decolonization and preoperative antibiotic prophylaxis play a role in reducing rates of CI infection. However, there remains a need for well designed clinical trials to provide higher level evidence to better guide preventive measures for, and management decisions of, CI infections in the future.

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“…This pain often presents in a delayed timeframe postoperatively, with a mean of 5.8 years in one study 4 . Vijendren et al recently proposed three possible causes for pain at the CI site: 1) biofilm of the device causing localized inflammation, 2) neurogenic pain, and 3) psychogenic pain 7 . To date, no study has systematically evaluated a cohort of pediatric patients that have undergone device removal in an attempt to uncover the etiology of persistent idiopathic CI pain.…”

Section: Introductionmentioning

confidence: 99%

Pain at the Cochlear Implant Site Requiring Device Removal in Pediatric Patients

et al. 2022

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Objectives Idiopathic pain at the cochlear implant (CI) site outside of the immediate postoperative period is an uncommon occurrence but may necessitate device explantation. Our objective was to describe the clinical course for pediatric patients with CI site pain who ultimately required device explantation. Study Design Retrospective chart review. Methods We performed a retrospective database review of CIs performed at a tertiary referral center for pediatric cochlear implantation. We specifically evaluated pediatric patients who presented with pain at or near the CI device site and ultimately required explantation. Results Fifteen patients (16 CIs) had pain at or near the CI site requiring device explantation. Cultures taken during site exploration or device explantation identified bacteria in 86% and 81% of procedures, respectively. Propionibacterium acnes and Staphylococcus non‐aureus were the most commonly identified organisms. Conclusions The majority of patients with idiopathic pain in this cohort ultimately requiring CI explantation had chronic bacterial colonization. Level of Evidence 4 (Case series) Laryngoscope, 132:2044–2049, 2022

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

Cited by 9 publications

References 10 publications

Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

An overview of risk factors, management and prevention of cochlear implant infections

Pain at the Cochlear Implant Site Requiring Device Removal in Pediatric Patients

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