Cochlear Implant Infections

Cochlear implants are the gold-standard treatment for profound sensorineural hearing loss. Cochlear implants are associated with a 1.7–4.1% risk of infection, with most infections occurring >30 days postoperatively and many occurring months to years later. Infections include surgical site infection, infection of the device itself, otitis media, mastoiditis, cochlear infection, and meningitis. Preoperative vaccination against Streptococcus pneumoniae is recommended to reduce the risk of post-implant pneumococcal meningitis. Special considerations must be taken when planning cochlear implant surgery in patients with recurrent or chronic middle ear disease to reduce the otherwise increased risk of postoperative infection in these patients. This chapter reviews the various types of cochlear implant-related infections along with their diagnosis, treatment, and prevention.