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Published on: August 4, 2023
Pain at the Cochlear Implant Site Requiring Device Removal in Pediatric Patients
A Eliot Shearer1,2, Alicia Wang1, Maranda Lawton1
1Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A.
Insights
Pediatric cochlear implant (CI) site pain often indicates bacterial colonization and may necessitate device removal. This study highlights chronic infection as a key factor in CI explantation for children experiencing site pain.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Medical Device Infections
Background:
- Idiopathic pain at the cochlear implant (CI) site, occurring after the initial recovery period, is rare but can lead to device explantation.
- Understanding the causes of such pain is crucial for managing pediatric CI patients.
Purpose of the Study:
- To describe the clinical course of pediatric patients experiencing CI site pain that ultimately required device explantation.
- To investigate potential underlying causes, such as infection, in cases of CI site pain.
Main Methods:
- Retrospective chart review of pediatric patients who underwent cochlear implantation at a tertiary referral center.
- Evaluation of patients presenting with pain at or near the CI device site requiring explantation.
- Analysis of microbiological cultures obtained during site exploration or device explantation.
Main Results:
- Fifteen pediatric patients (16 cochlear implants) experienced CI site pain necessitating explantation.
- Bacterial presence was identified in 86% of site explorations and 81% of explantations.
- Commonly identified bacteria included Propionibacterium acnes and Staphylococcus non-aureus.
Conclusions:
- Chronic bacterial colonization is a frequent finding in pediatric patients requiring cochlear implant explantation due to idiopathic site pain.
- Infection should be strongly suspected in pediatric CI patients presenting with persistent site pain.
Objectives:
Idiopathic pain at the cochlear implant (CI) site outside of the immediate postoperative period is an uncommon occurrence but may necessitate device explantation. Our objective was to describe the clinical course for pediatric patients with CI site pain who ultimately required device explantation.
Study Design:
Retrospective chart review.
Methods:
We performed a retrospective database review of CIs performed at a tertiary referral center for pediatric cochlear implantation. We specifically evaluated pediatric patients who presented with pain at or near the CI device site and ultimately required explantation.
Results:
Fifteen patients (16 CIs) had pain at or near the CI site requiring device explantation. Cultures taken during site exploration or device explantation identified bacteria in 86% and 81% of procedures, respectively. Propionibacterium acnes and Staphylococcus non-aureus were the most commonly identified organisms.
Conclusions:
The majority of patients with idiopathic pain in this cohort ultimately requiring CI explantation had chronic bacterial colonization.
Level Of Evidence:
4 (Case series) Laryngoscope, 132:2044-2049, 2022.
