title: Cerebrospinal fluid gusher in cochlear implantation.
abstract: OBJECTIVE
  To share our experience of cerebrospinal fluid (CSF) gusher in cochlear implantation.
  
  
  METHODS
  Demographic, radiological, and surgical results of patients with CSF gusher in 523 consecutive cochlear implant recipients including children and adults as well as our management technique were evaluated and a review of the literature has been included.
  
  
  RESULTS
  Fifteen (2.87%) cases had CSF gusher. Two patients (13.3%) were adults with post-lingual hearing loss and the rest 12 (86.7%) were children with congenital hearing loss. Twelve patients (80%) had various types of inner ear malformation. Three patients (20%) had no predictable risk of CSF gusher from history or pre-operative imaging. In all patients, CSF gushers were controlled with our technique of packing the electrode entrance site with no additional measures.
  
  
  CONCLUSIONS
  CSF gusher may occur with post-lingual hearing loss and in children with apparently unremarkable imaging and history. Thus, surgeons should always be ready to manage it. Management of CSF gusher can be mainly performed during the initial surgery by precise tight packing of the electrode entrance site. Furthermore, non-surgical or surgical measures are rarely required to stop a persistent leak. Our results show that our management technique may be recommended as well.
authors.forename: Ali
authors.initials: A
authors.lastname: Eftekharian
authors.forename: Maryam
authors.initials: M
authors.lastname: Amizadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects* / Q000401:mortality; D007758:Ear, Inner / Q000002:abnormalities / Q000000981:diagnostic imaging; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012405:Round Window, Ear
keywords: CSF gusher; Cochlear implant; Complication; Inner ear malformation; Management