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[Treatment of acute mastoiditis in children with cochlear implants]
Verónica Rodríguez1, Laura Cavallé, Carlos De Paula
1Hospital Universitario La Fe de Valencia, Universidad de Valencia, Valencia, España. pecasve@hotmail.com
Insights
Acute mastoiditis (AM) in pediatric cochlear implant (CI) patients occurs in 2.01% of cases. Conservative management with antibiotics is recommended to avoid CI contamination and preserve hearing function.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Medical Device Complications
Background:
- Acute mastoiditis (AM) is a serious pediatric infection.
- AM poses unique challenges in children with cochlear implants (CI).
Observation:
- A retrospective study analyzed 248 pediatric CI cases (1994-2009).
- Five patients (2.01%) developed AM, three with subperiosteal abscess (1.21%).
- AM occurred 1-33 months post-implantation in children with a mean age of 3 years and 4 months.
Findings:
- The incidence of AM in this pediatric CI cohort was 2.01%.
- Pre-implantation otitis media was noted in four patients.
- All cases involved Nucleus CI devices.
Implications:
- Conservative management, including IV antibiotics and abscess puncture, is advised for AM in pediatric CI patients.
- Surgical intervention should be minimized to prevent CI contamination.
- Radiological assessment is crucial if surgical drainage is necessary to protect CI electrode placement.
Introduction:
Acute mastoiditis (AM) is a paediatric infectious complication that raises a specific problem in case of implanted patients.
Objective:
To review the cases of AM in a paediatric cochlear implant (CI) programme to study its incidence and associated problems.
Materials And Methods:
A retrospective study was conducted on 248 children aged between 8 months and 14 years who underwent CI from 1994 to 2009. The demographics, clinical data and their treatment were analyzed.
Results:
Five patients developed acute mastoiditis (2.01%), three of them with subperiosteal abscess (1.21%). The mean age of implantation was 2 years and 4 months, and the complication presented between 1 and 33 months post-implantation (mean, 11.6 months). Four patients had episodes of serous otitis preimplantation. The mean age of AM patients was of 3 years and 4 months. The CI type was nucleus in all cases.
Conclusions:
Conservative management is suggested for AM and subperiosteal abscess in children with cochlear implants. Surgical treatment should be avoided to prevent CI contamination. The first option is intravenous antibiotics and simple puncture of the abscess. If surgical drainage is needed, radiological study should be performed to locate the CI electrodes.
