Management of acute mastoiditis in cochlear implanted children

Objectives: Discuss diagnosis and therapeutic management of acute mastoiditis in cochlear implanted children. Methodology: This paper is a retrospective chart review of 280 cochlear implanted children operated on over a period of 13 years [2003-2015]. Five patients developed acute mastoiditis and were included in this study. Their demographics, clinical data and treatment were analysed. Results: Five patientsdeveloped acute mastoiditis (1.78%). Two patients had a history of meningitis prior to implantation. The average age of implantation was 39 months and the mean delay from implantation to mastoiditis was seven months. Intravenous antibiotherapy was indicated in all cases. Post-auricular drainage and a myringotomy with tube insertion were indicatedin one case. Recurrence was noted in two cases. Prolonged antibiotherapy was indicated in both cases, with additional surgical drainage in one of these two patients. Recovery was observed in all cases. Conclusion: Conservative management is suggested for acute mastoiditis in children with cochlear implants. Prolonged antibiotherapy with drainage of frank abscesses may be crucial to control the infection. The main tools of prevention remain close observation and early management of acute otitis in cochlear implanted children who are of an age at which otitis media is particularly common.