Incidence of acute otitis media and mastoiditis in cochlear implanted children

Objectives: To examine the incidence of acute otitis media (AOM)and mastoiditis in children after cochlear implantation (CI) and to evaluate the role of mastoidectomy on the natural history of AOM in implanted children by comparing surgical approaches.Methods: Retrospective case review. The study cohort included children up to age 8 years at the time of CI between 1993–2001 and followed-up at least 28 months. One hundred forty-five children were divided into 2 groups. One group (97 children) underwent the classic mastoidectomy posterior tympanotomy approach (MPTA) and the other group (48 children) underwent cochlear implantation using the suprameatal approach (SMA) without mastoidectomy. The incidence of AOM and mastoiditis before and after the implantation was compared between the 2 groups.Results: Fifty-five of the 145 children had a history of one or more episodes of AOM prior to implantation. The incidence of pre- and postimplantation AOM was similar for the 2 groups (P = 0.6607 and P = 0.5104, respectively). Mastoiditis developed in 8 children, all but 1 older than 2 years of age and all in the MPTA group.Conclusions: AOM and mastoiditis represents common complications of CI surgery and are successfully treated by antibiotics. The incidence of post-CI AOM was lower than that of pre-CI AOM, a finding unrelated to the surgical approach. Mastoiditis occurred only in the MPTA group.