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Leflunomide-Associated Wound Complication After Cochlear Implantation: A Case Report
Vikas Munjal1, Robert J Macielak2, Vivian F Kaul2
1College of Medicine, The Ohio State University, Columbus, OH, USA.
The Annals of Otology, Rhinology, and Laryngology
|July 26, 2024
Summary
Cochlear implant infections may occur in patients taking immunosuppressants like disease-modifying anti-rheumatic drugs (DMARDs). A case study showed wound complications resolved after a drug holiday, suggesting careful management is needed.
Area of Science:
- Otolaryngology
- Rheumatology
- Infectious Disease
Background:
- Cochlear implantation (CI) is a common treatment for severe hearing loss.
- Immunosuppressive therapies, such as disease-modifying anti-rheumatic drugs (DMARDs), are widely used for autoimmune conditions.
- An increasing number of patients undergoing CI are on immunosuppressive medications, raising concerns about potential complications.
Purpose of the Study:
- To investigate the risk of cochlear implant-associated infections in patients using immunosuppressive therapy.
- To highlight potential wound complications in patients on DMARDs undergoing cochlear implantation.
Main Methods:
- Retrospective chart review.
- Comprehensive literature review.
- Case presentation of an 81-year-old male with rheumatoid arthritis on leflunomide.
Main Results:
- The patient experienced wound dehiscence and infection after cochlear implantation while on leflunomide.
- Complications resolved after a temporary cessation of the DMARD (drug holiday).
- The patient successfully underwent cochlear reimplantation after the infection resolved.
Conclusions:
- This case highlights a potential link between DMARD therapy and cochlear implant wound complications.
- Further research is warranted to understand the interaction between immunosuppressive therapy and CI outcomes.
- Perioperative management strategies need to be developed for patients on immunosuppressants undergoing cochlear implantation.
