title: Preventing complications in pediatric cochlear implantation.
abstract: OBJECTIVE
  This review addresses four key areas of controversy in the prevention of common complications of pediatric cochlear implant surgery: reducing meningitis risk, managing acute otitis media (AOM) in the cochlear implant population, assessing the optimum age for implanting a child to take advantage of the critical periods of language acquisition, and managing the social risk in defining ethical issues still surrounding cochlear implant in children.
  
  
  RESULTS
  Improved surgical techniques and the replacement of Prenvar-7 with Prenvar-13 significantly reduce the risk of cochlear implant related meningitis. AOM within 2 months of cochlear implant placement requires aggressive management to reduce the risk of complication. Tympanostomy tubes do not increase the risk of otitis media or meningitis and should be used when appropriate according to accepted AOM standards. Although the controversy over cochlear implant and the dissolution of Deaf Culture is decreasing, the use of cochlear implant in children remains an area for open dialogue between groups to ensure children are treated appropriately. Discussions ought to be based on fact and scientific evidence.
  
  
  CONCLUSIONS
  Although cochlear implants remain the gold standard for hearing restoration in children with severe to profound hearing loss, several issues remain controversial and are in need of further scientific exploration.
authors.affiliation: Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, Washington 98122, USA.
authors.forename: Myles F
authors.initials: MF
authors.lastname: Melton
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Backous
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000941:ethics; D003054:Cochlear Implants; D006801:Humans; D007223:Infant; D007804:Language Development; D008581:Meningitis / Q000517:prevention & control; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control*