Infectious complications in pediatric cochlear implants.
OBJECTIVE
Infectious complications may cause significant delay in cochlear implant device initiation and programming and be a source of additional morbidity. We reviewed our experience with infectious complications in the pediatric age group to determine specific sources that may not be seen in adults.


METHODS
A retrospective analysis from a single implant center.


METHODS
Cases of pediatric cochlear implants were reviewed for data on infectious complications. Complications were identified as "major" or "minor," "early" or "delayed." Information was gathered regarding any comorbid, chronic health condition. Data related to the causative organism(s) were collected.


RESULTS
Two hundred sixty-eight cases of pediatric implants were reviewed. Twenty-two cases were identified (an infection rate of 8.2%), all classified as "major." The majority, 12, were classified as "delayed" complications. Twenty-one cases required explantation with 14 successfully reimplanted. Five cases (in 4 patients) or 23% were associated with a specific chronic pediatric condition including two children with tracheostomies. Among implanted children who had chronic health conditions, 42% developed implant-related infections. Among otherwise healthy implanted children, only 6.6% developed implant-related infections. Resistant bacterial infections were not identified.


CONCLUSIONS
Health conditions in the pediatric age group were associated with 23% of our complications, a risk factor not previously identified in the literature. These children, demonstrating seven times the infection rate of healthy children, should be carefully observed postoperatively. Overall, cochlear implantation in children continues to be associated with a low risk of infectious complications.
Hopfenspirger
Michael T
MT
Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA. hopfe007@umn.edu
Levine
Samuel C
SC
Rimell
Frank L
FL
D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology; D003054:Cochlear Implants / Q000382:microbiology* / Q000706:statistics & numerical data*; D003638:Deafness / Q000151:congenital / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification