Related Experiment Videos
Mastoiditis and acute otitis media in children with cochlear implants: recommendations for medical management
H G Kempf1, T Stöver, T Lenarz
1Department of Otolaryngology, Medical University of Hannover, Germany.
Abstract:
Acute otitis media (OM) or mastoiditis is a very dangerous condition for the ear after cochlear implantation. However, acute OM is very common in childhood and can occasionally occur in an implanted ear. Most cases of acute OM can be successfully treated with intravenous high-dosage antibiotics. In cases of mastoiditis and clinical signs of mastoid abscess, retroauricular drainage is necessary to prevent infection of the implant bed. In a series of 366 children given implants (1 to 14 years), acute OM occurred in 5.6% during a follow-up period of 1 to 8 years. Seven ears had to be opened by means of myringotomy. Five ears were opened by retroauricular incision with mastoid revision on the implanted side. Adenoidectomy and use of ventilation tubes before cochlear implantation, as well as careful subtotal mastoidectomy during the implantation, can reduce the incidence of acute OM in children after implantation. Early and subsequent treatment with operative mastoid drainage can prevent implant loss and should be performed at the implantation center.
Insights
Acute otitis media (OM) is common in children and can affect cochlear implant recipients. Prompt antibiotic treatment and surgical drainage for mastoiditis can prevent serious complications and implant loss.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Neurosurgery
Background:
- Acute otitis media (OM) and mastoiditis pose significant risks to cochlear implant recipients.
- OM is prevalent in childhood and can occur in implanted ears, potentially leading to severe complications.
Purpose of the Study:
- To evaluate the incidence of acute otitis media in pediatric cochlear implant recipients.
- To assess the effectiveness of current treatment strategies and identify preventive measures for OM in this population.
Main Methods:
- A retrospective review of 366 children (ages 1-14) who received cochlear implants.
- Analysis of OM incidence, treatment interventions (antibiotics, myringotomy, retroauricular drainage), and outcomes over a 1-8 year follow-up period.
Main Results:
- Acute otitis media occurred in 5.6% of pediatric cochlear implant recipients.
- Seven ears required myringotomy, and five needed retroauricular incision with mastoid revision for mastoiditis or abscess.
- Intravenous high-dose antibiotics were effective for most OM cases, while mastoiditis necessitated surgical drainage.
Conclusions:
- Preventive strategies such as adenoidectomy, ventilation tubes, and meticulous subtotal mastoidectomy during implantation can decrease OM incidence.
- Early recognition and prompt operative mastoid drainage are crucial for preventing cochlear implant loss.
- Management of OM and mastoiditis in cochlear implant recipients should be handled at specialized implantation centers.