Bacterial infection complications in children with cochlear implants in the Czech Republic.
OBJECTIVE
Studies describing wound infections after cochlear implantation are rare. Meticulous operative techniques and sufficient surgical skill can help to avoid severe postoperative complications. Minor complications such as seromas, superficial wound infections, skin emphysema, and swelling can all be successfully treated using conservative methods. Serious problems, however, could be caused by Pseudomonas aeruginosa and Staphylococcus aureus infections.


METHODS
Retrospective case series.


METHODS
Pediatric cochlear implant center in the Czech Republic.


RESULTS
In our cohort of 360 children operated on between 1994 and 2009, there were no major surgical complications. However, there were four serious wound infections, two of which resulted in explantation of the device. Two patients with a well-bordered abscess formation were successfully treated with antibiotics and drainage. Explantation was required in another two children with refractory P. aeruginosa infection. Despite favorable sensitivity to a number of antibiotics, intravenous and intensive local treatment failed. After explantation, the operative sites healed immediately. Both children were successfully implanted contralaterally 6 months later. Detailed bacteriological tests from different parts of the device were performed.


CONCLUSIONS
The consequences of explantation were discussed in our cochlear implant center. Confirmed by the microbiological results and reports in the scientific literature, it seems preferable to cut the electrode near the cochlear array and leave it inside the cochlea in order to use the same ear for reimplantation at a later date.
Kabelka
Zdenek
Z
Department of Otolaryngology, Charles University, 2nd Medical School and Faculty Hospital Motol, V Uvalu 84, Praha 150 06, Czech Republic. Zdenek.Kabelka@fnmotol.cz
Groh
Daniel
D
Katra
Rami
R
Jurovcik
Michal
M
D000038:Abscess / Q000382:microbiology / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants; D018153:Czech Republic; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000209:etiology* / Q000628:therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012086:Reoperation; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000209:etiology* / Q000628:therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000209:etiology* / Q000628:therapy*
D000900:Anti-Bacterial Agents