Cochlear implant explantation as a sequela of severe chronic otitis media: Case report and review of the literature

Introduction: In the 1980s, intracranial and inner car infections were feared complications in patients with recurrent or chronic otitis media (COM) who had undergone cochlear implantation. Current studies show a low incidence of such complications. We present a case of a patient who developed severe COM requiring cochlear explantation. Case: Our patient had a previous cleft palate repair and as a three-year-old was implanted with a Nucleus-24 implant. She developed chronic otorrhea in the implanted ear, which was managed by her pediatrician until her cochlear implant stopped functioning. Radiographic imaging revealed erosion of the cochlea and extrusion of the distal electrode medially in the petrous apex. Setting: Tertiary care university hospital. Intervention/Results: The patient underwent cochlear explantation, subtotal petrosectomy, obliteration of ear, and intravenous antibiotic therapy. One month later she was implanted in the contralateral ear. Conclusion: COM poses potentially severe complications in patients receiving cochlear implants. Patients receiving cochlear implants who are at high risk for COM require follow-up for an extended period of time.