title: Infected cochlear implant after large-volume nasal irrigation.
abstract: OBJECTIVE
  A patient with a well-healed, functional cochlear implant (CI) experienced a CI and mastoid infection shortly after initiating large-volume nasal irrigations after sinus surgery. The goal of this report is to bring attention to a rare complication and to question if large-volume nasal irrigation is safe in CI recipients.
  
  
  METHODS
  Single patient at a tertiary care hospital.
  
  
  METHODS
  A CI recipient began using large-volume nasal irrigations with saline and budesonide after undergoing sinus surgery.
  
  
  METHODS
  CI infection and mastoiditis.
  
  
  RESULTS
  Two weeks after starting nasal irrigations, the patient presented with mastoiditis and CI infection. Mastoid and intranasal middle meatal cultures both grew Group A streptococcus.
  
  
  CONCLUSIONS
  Large-volume nasal irrigations may be related to our patient's CI infection, ultimately leading to explantation. Though a causal relationship cannot be definitively proven, awareness of this potential safety issue should be disseminated.
authors.affiliation: Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, U.S.A.
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Cain
authors.forename: Devyani
authors.initials: D
authors.lastname: Lal
authors.forename: David M
authors.initials: DM
authors.lastname: Barrs
mesh_terms: D000281:Administration, Intranasal; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D019819:Budesonide / Q000008:administration & dosage*; D019929:Cochlear Implantation; D003054:Cochlear Implants / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008417:Mastoiditis / Q000209:etiology*; D055556:Nasal Lavage / Q000009:adverse effects*; D010256:Paranasal Sinuses / Q000601:surgery; D012220:Rhinitis / Q000601:surgery; D012852:Sinusitis / Q000601:surgery; D012965:Sodium Chloride / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D012965:Sodium Chloride; D019819:Budesonide