Cochlear implantation in psoriasis patients.

Cochlear implantation has become a safe and effective method for the auditory rehabilitation of severe to profound sensorineural hearing loss. Flap problems are the commonest of the surgical complications [Axon PR, Mawman DJ, Upile T, Ramsden RT. Cochlear implantation in the presence of chronic suppurative otitis media. J Laryngol Otology 1997;111:228-32] and the risk increases further when associated with medical conditions predisposing to infection. We present two patients with psoriasis who underwent cochlear implant surgery, discussing the risk of surgical site infection and treatment options to minimise infection.

Cochlear implantation and management of chronic suppurative otitis media: single stage procedure?

In a series of 360 patients who underwent cochlear implantation at our center, four patients (five procedures) had cochlear implantation with obliteration of the mastoid cavity and management of cholesteatoma as a single-staged procedure. Three patients were bilaterally deaf secondary to CSOM and had bilateral mastoid cavities, and in one patient congenital cholesteatoma was identified during cochlear implantation. A mastoidectomy or revision mastoidectomy with obliteration of the mastoid cavity and cochlear implantation was performed as a single stage procedure. Cholesteatoma reoccurred in one patient 9 years after cochlear implantation. Surgical procedures, complications, follow-up and outcomes are discussed.

Short-term versus long-term antibiotic prophylaxis in cochlear implant surgery.

OBJECTIVE: The objective of this study to evaluate antibiotic prophylaxis options for cochlear implant surgery. Does long-term antibiotic prophylaxis have any advantage over a single perioperative dose in preventing postoperative infection? STUDY DESIGN: We conducted a retrospective case review. PATIENTS: A total of 292 adult and pediatric patients who underwent cochlear implantation during a 15-year period (1988-2003) were reviewed. MAIN OUTCOME MEASURE: Minor and major postoperative wound infections in first 4 weeks. RESULTS: There were four major and eight minor complication among 292 patients (complication rate 4.1%). The infection rate was higher in patients who had either C incision (11.1%) or extended endaural incision (7.5%) and in patients with a preexisting medical condition. The infection rate was also higher in patients who had long-term antibiotics (5.6% and 13% in the 5-d and 7-d regimes) compared with short-term (single-dose) group. CONCLUSION: Long-term antibiotic prophylaxis did not have any advantage over single perioperative dose. Predisposing medical conditions and extensive surgical incisions were associated with a greater severity of infections and higher risk of wound complications.