Treatment of acute mastoiditis in children with cochlear implants

Introduction: Acute mastoiditis (AM) is a paediatric infectious complication that raises a specific problem in case of implanted patients. Objective: To review the cases of AM in a paediatric cochlear implant (CI) programme to study its incidence and associated problems. Materials and methods: A retrospective study was conducted on 248 children aged between 8 months and 14 years who underwent CI from 1994 to 2009. The demographics, clinical data and their treatment were analyzed. Results: Five patients developed acute mastoiditis (2.01%), three of them with subperiosteal abscess (1.21%). The mean age of implantation was 2 years and 4 months, and the complication presented between 1 and 33 months post-implantation (mean, 11.6 months). Four patients had episodes of serous otitis preimplantation. The mean age of AM patients was of 3 years and 4 months. The CI type was nucleus in all cases. Conclusions: Conservative management is suggested for AM and subperiosteal abscess in children with cochlear implants. Surgical treatment should be avoided to prevent CI contamination. The first option is intravenous antibiotics and simple puncture of the abscess. If surgical drainage is needed, radiological study should be performed to locate the CI electrodes. (C) 2009 Elsevier Espana, S.L. All rights reserved.