Mastoiditis and Acute Otitis Media in Children with Cochlear Implants: Recommendations for Medical Management

• Published in: Annals of otology, rhinology & laryngology Vol. 109; no. 12_suppl; pp. 25 - 27
• Main Authors: Kempf, Hans-Georg, Stöver, Timo, Lenarz, Thomas
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.12.2000; SAGE PUBLICATIONS, INC
• Subjects: Acute Disease; Adolescent; Anti-Bacterial Agents - therapeutic use; Child; Child, Preschool; Cochlear Implants; Follow-Up Studies; Humans; Infant; Mastoid - surgery; Mastoiditis - drug therapy; Mastoiditis - surgery; Mastoiditis - therapy; Otitis Media - drug therapy; Otitis Media - surgery; Otitis Media - therapy; Postoperative Complications - drug therapy; Postoperative Complications - surgery; Postoperative Complications - therapy; Time Factors
• ISSN: 0003-4894; 0096-8056; 1943-572X
• DOI: 10.1177/0003489400109S1210

Acute otitis media (OM) or mastoiditis is a very dangerous condition for the ear after cochlear implantation. However, acute OM is very common in childhood and can occasionally occur in an implanted ear. Most cases of acute OM can be successfully treated with intravenous high-dosage antibiotics. In cases of mastoiditis and clinical signs of mastoid abscess, retroauricular drainage is necessary to prevent infection of the implant bed. In a series of 366 children given implants (1 to 14 years), acute OM occurred in 5.6% during a follow-up period of 1 to 8 years. Seven ears had to be opened by means of myringotomy. Five ears were opened by retroauricular incision with mastoid revision on the implanted side. Adenoidectomy and use of ventilation tubes before cochlear implantation, as well as careful subtotal mastoidectomy during the implantation, can reduce the incidence of acute OM in children after implantation. Early and subsequent treatment with operative mastoid drainage can prevent implant loss and should be performed at the implantation center.