Management of Severe Cochlear Implant Infections-35 Years Clinical Experience

Infectious complications occurring in cochlear implant (CI) recipients is of potentially major impact. A better understanding of severe infections in this cohort is necessary.

Single-center, retrospective cohort study. Level of Evidence 2B.

Single-center, retrospective cohort study at a tertiary referral hospital.

We included all patients who received a CI at our institution between 1983 and end of 2018 (4,622 implantations).

Prevalence, incidence, risk factors, and functional outcomes in severe implant infections.

There was an overall prevalence of 0.65% of severe CI infections. The cumulative incidence decreased after the year 2000, with lower infection rates with newer implant models. Patients with local risk factors were more susceptible to implant infection. In most patients, delayed re-implantation was successful. Speech-perception after re-implantation was comparable to pre-revision performance.

Modified implant design and improved surgical technique has led to a decrease in the prevalence and incidence of infected implants. In severe implant infections, active surgical and antimicrobial management is required, to achieve good long-term results.