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Published on: August 4, 2023
Infectious complications in pediatric cochlear implants
Michael T Hopfenspirger1, Samuel C Levine, Frank L Rimell
1Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA. hopfe007@umn.edu
Insights
Pediatric cochlear implant infections, often delayed, are linked to chronic health conditions, increasing risk sevenfold. Careful postoperative observation is crucial for these children, though overall infection risk remains low.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Infectious Diseases
Background:
- Infectious complications can significantly delay cochlear implant (CI) initiation and programming, leading to increased morbidity in pediatric patients.
- Understanding specific sources of infection in children is crucial as they may differ from adult populations.
Purpose of the Study:
- To review the experience with infectious complications in pediatric cochlear implant recipients.
- To identify specific risk factors and sources of infection in this age group.
Main Methods:
- A retrospective analysis of pediatric cochlear implant cases from a single center.
- Infectious complications were classified as major/minor and early/delayed, with data collected on comorbidities, chronic health conditions, and causative organisms.
Main Results:
- An infection rate of 8.2% (22/268 cases) was observed, all classified as major complications.
- Delayed complications (12 cases) were more common. Five cases (23%) were associated with chronic pediatric conditions, including tracheostomies. Children with chronic conditions had a 42% infection rate versus 6.6% in healthy children.
- No resistant bacterial infections were identified.
Conclusions:
- Chronic health conditions are a significant risk factor for infectious complications in pediatric cochlear implant recipients, increasing infection rates sevenfold compared to healthy children.
- These findings highlight the need for careful postoperative monitoring in pediatric CI patients with underlying health issues.
- Cochlear implantation in children remains a procedure with a generally low risk of infectious complications.
Objectives:
Infectious complications may cause significant delay in cochlear implant device initiation and programming and be a source of additional morbidity. We reviewed our experience with infectious complications in the pediatric age group to determine specific sources that may not be seen in adults.
Study Design:
A retrospective analysis from a single implant center.
Methods:
Cases of pediatric cochlear implants were reviewed for data on infectious complications. Complications were identified as "major" or "minor," "early" or "delayed." Information was gathered regarding any comorbid, chronic health condition. Data related to the causative organism(s) were collected.
Results:
Two hundred sixty-eight cases of pediatric implants were reviewed. Twenty-two cases were identified (an infection rate of 8.2%), all classified as "major." The majority, 12, were classified as "delayed" complications. Twenty-one cases required explantation with 14 successfully reimplanted. Five cases (in 4 patients) or 23% were associated with a specific chronic pediatric condition including two children with tracheostomies. Among implanted children who had chronic health conditions, 42% developed implant-related infections. Among otherwise healthy implanted children, only 6.6% developed implant-related infections. Resistant bacterial infections were not identified.
Conclusions:
Health conditions in the pediatric age group were associated with 23% of our complications, a risk factor not previously identified in the literature. These children, demonstrating seven times the infection rate of healthy children, should be carefully observed postoperatively. Overall, cochlear implantation in children continues to be associated with a low risk of infectious complications.
