Postoperative infections following cochlear implant surgery

Olsen, Lilian Bostlund; Larsen, S.; Wanscher, Jens Højberg; Faber, Christian Emil; Jeppesen, Jonas

doi:10.1080/00016489.2018.1482422

Cited by 24 publications

(33 citation statements)

References 15 publications

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“…and Pseudomonas spp. were the commonly identified bacteria in the vast majority of studies . Recognised subtypes of Staphylococcal spp.…”

Section: Resultsmentioning

confidence: 99%

“…Biofilm production on package complexes has been suggested as one of the main contributing factors in delayed and recurrent wound infections . Olsen et al had visually assessed their infected implants during surgical treatment for biofilms and sent swabs away for microbiological culture and sensitivities.…”

Section: Resultsmentioning

confidence: 99%

“…They noted that 8 out of 11 infected implants had biofilm growths of which 7 were ultimately explanted. Five of these implants cultivated Staphylococcal aureus . In Palau et al's series, scanning electron microscopes were used to examine the 3 explanted CIs, where 2 were noted to have Staphylococcal aureus and epidermidis biofilms on them…”

Section: Resultsmentioning

confidence: 99%

“…It was provided microbiological swabs had not displayed resistance or grown an organism sensitive to another microbial agent. In severe cases, intravenous cephalosporins were used in combination with metronidazole …”

Section: Resultsmentioning

confidence: 99%

“…The introduction and expansion of cochlear implantation (CI) technology has revolutionised the management of profound hearing loss worldwide . Despite being a relatively straightforward operation, complications can be disastrous with infection contributing to significant morbidity …”

Section: Introductionmentioning

confidence: 99%

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

Vijendren

Borsetto

Barker

et al. 2019

Clinical Otolaryngology

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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.

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“…and Pseudomonas spp. were the commonly identified bacteria in the vast majority of studies . Recognised subtypes of Staphylococcal spp.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Vijendren

Borsetto

Barker

et al. 2019

Clinical Otolaryngology

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Comparison of Adult and Pediatric Cochlear Implant Wound Complications: AMeta‐Analysis

et al. 2022

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Objective To compare age‐related differences in wound complications following cochlear implantation (CI). Methods We performed a systematic review of PubMed, Cochrane Database, and Web of Science databases to identify original research evaluating the patient‐level factors (demographics and medical history) associated with wound complications following CI. Outcomes were expressed as relative risk (RR) with 95% confidence intervals using the inverse variance method. Studies without comparison groups were described qualitatively. Results Thirty‐eight studies representing 21,838 cochlear implantations were included. The rate of wound complications ranges from 0% to 22%. Patient age (adult versus pediatric) was the only factor with comparison groups appropriate for meta‐analysis. The 10 studies (n = 9547 CI's) included in the meta‐analysis demonstrated that adults had a higher incidence of overall wound complications (2.94%) than in children (2.44%) (RR 1.31, 95% CI 1.01–1.69). Adults had a higher incidence of general/unclassified wound complications (2.07%) than in children (1.34%) (RR 1.68, 95% CI 1.12–2.52). There was no difference between adults and children for specific complications such as hematoma, infection, or seroma. Elderly patients (over age 75) have wound complication rates that range from 1% to 4%. No studies contained comparison groups regarding other patient‐level factors and CI wound complications. Conclusion CI wound complication rates reported in the literature are low; however, adults have a higher risk of these complications than pediatric patients. The reported complication rate in elderly adults is low. There is a gap in CI research in consistently reporting wound complications and rigorous research investigating the impact of patient‐level factors and wound complications. Level of Evidence NA Laryngoscope, 133:218–226, 2023

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New validation of a well‐known marker in cochlear implant infections: A retrospective, case‐controlled, observational study

Önal

Keles

Ulusoy

et al. 2022

Laryngoscope Investig Oto

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Objectives Cochlear implant (CI) infection is the most common complication after CI surgery. We investigated whether the preoperative neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) values could predict the CI infection and the NLR and PLR values obtained at the first admission to the hospital with an CI infection could help the clinician in the diagnosis. Methods This retrospective case‐controlled study included 26 patients with postsurgical CI infection. To prevent age‐related incompatibility in the blood analysis of the infected group, the patients were divided into three age groups: 0–4 years, 5–18 years, and over 18 years old. To compare the infected group, 29 patients who did not have implant infection after CI surgery and whose age ranges were compatible with the infected group were randomly selected from the hospital records as the control group. The infected group preimplantation (PREs) and postinfection (POSTi) NLR and PLR values were compared with each other and the control group values. The area under the curve, sensitivity, specificity, and cutoff values were calculated by ROC analysis. Results The POSTi NLR values of the infected group patients aged 0–4 years and over 18 years were significantly greater than the PREs NLR values (p = .038 and p = .008, respectively). Significant differences were found between the POSTi NLR values of the infected group patients aged 0–4 years and over 18 years and those of PREs in the control group (p = .011 and p = .015, respectively). Conclusions Preoperative NLR and PLR values cannot predict postoperative CI infection. However, NLR and PLR values increased significantly after CI infection, even if systemic symptoms did not occur. At the first admission to the hospital, NLR values can guide the clinician in diagnosing the CI infection in patients between 0 and 4 years and over 18 years. Trial Registration Clinical Trials.gov Identifier: NCT04120181.

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Postoperative infections following cochlear implant surgery

Abstract: Postoperative infection occurred in 10% of the implantations. However, few of these were severe. Staphylococcus aureus was the most common pathogen and the presence of biofilm seemed to be associated with a higher risk of explantation.

Cited by 24 publications

References 15 publications

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

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

Comparison of Adult and Pediatric Cochlear Implant Wound Complications: AMeta‐Analysis

New validation of a well‐known marker in cochlear implant infections: A retrospective, case‐controlled, observational study

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