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Published on: February 29, 2020
Infected cochlear implant after large-volume nasal irrigation
Rachel B Cain1, Devyani Lal, David M Barrs
1Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, U.S.A.
Insights
Large-volume nasal irrigation may cause cochlear implant (CI) infections in recipients. This case report highlights a rare complication, suggesting caution with nasal irrigation post-sinus surgery for CI users.
Area of Science:
- Otolaryngology
- Infectious Disease
- Biomedical Engineering
Background:
- Cochlear implants (CI) are vital for hearing restoration.
- Sinus surgery is common, and nasal irrigations are often recommended post-operatively.
- Large-volume nasal irrigations are increasingly used for sinus conditions.
Observation:
- A patient with a functional CI developed a CI and mastoid infection after initiating large-volume nasal irrigations.
- The infection occurred shortly after sinus surgery and commencement of nasal irrigations.
- Cultures identified Group A Streptococcus in both the mastoid and nasal cavities.
Findings:
- The patient presented with mastoiditis and cochlear implant infection two weeks after starting nasal irrigations.
- Cochlear implant infection necessitated device explantation.
- Group A Streptococcus was identified as the causative agent.
Implications:
- Large-volume nasal irrigations may pose a risk of infection in cochlear implant recipients.
- This case suggests a potential link between nasal irrigation and CI/mastoid infections.
- Further research is warranted to establish causality and guide clinical practice regarding nasal irrigation safety in CI users.
Objective:
A patient with a well-healed, functional cochlear implant (CI) experienced a CI and mastoid infection shortly after initiating large-volume nasal irrigations after sinus surgery. The goal of this report is to bring attention to a rare complication and to question if large-volume nasal irrigation is safe in CI recipients.
Patients:
Single patient at a tertiary care hospital.
Interventions:
A CI recipient began using large-volume nasal irrigations with saline and budesonide after undergoing sinus surgery.
Main Outcome Measures:
CI infection and mastoiditis.
Results:
Two weeks after starting nasal irrigations, the patient presented with mastoiditis and CI infection. Mastoid and intranasal middle meatal cultures both grew Group A streptococcus.
Conclusion:
Large-volume nasal irrigations may be related to our patient's CI infection, ultimately leading to explantation. Though a causal relationship cannot be definitively proven, awareness of this potential safety issue should be disseminated.
