Conservative management of infections in cochlear implant recipients

OBJECTIVE The goal of this study was to evaluate a conservative management strategy of postoperative infection after cochlear implantation. METHODS: A retrospective review of the medical records of 108 cochlear impl ant patients operated on at the University of California, San Francisco bet ween 1991 and 2000 and 133 cochlear implant patients from the University of Iowa between 1997 and 2000 showed 4 patients with evidence of postoperativ e infections. The clinical presentation, intervention, laboratory results, and outcome are analyzed in each case. RESULTS: Minimal surgical intervention with limited incision and drainage w ith prolonged postoperative antibiotics was effective in treating postopera tive cochlear implant infections without the need for device removal. impla nt function remained unaffected after surgery. CONCLUSION: Postoperative cochlear implant infections can be effectively co ntrolled with limited surgical and prolonged medical management. Chronic im plant infections may be explained by a primary immunodeficiency. With appro priate treatment leading to infection control, a conservative management st rategy is advocated before consideration of device explantation.