Cochlear implant infection due to cholesteatoma

There are an increasing number of young children undergoing cochlear implantation. Cholesteatoma is a serious, although rare, long-term complication. We present the only documented case in which cholesteatoma has presented with late abscess formation in the bed of a cochlear implant package of a child. Cholesteatoma may be an iatrogenic complication of implantation surgery. Damage to the bony part of the external auditory canal should be avoided. The successful two-staged surgical treatment using explantation, debridement, gentamycin bead insertion, cholesteatoma excision and modified radical mastoidectomy is described. The intra-cochlear electrode was removed precluding cochlear implant reimplantation. This late presentation supports regular long-term otoscopic review of cochlear implant patients by experienced otologists. Suspicion should be raised in patients with persistent otorrhoea.