Pediatric otitis media post cochlear implant retrospective cohort study


  • Abdallah Atwa El Deghadey Department of Otorhinolaryngology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
  • Saad Eldesoky Elzayat Department of Otorhinolaryngology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
  • Sayed Mahmoud Mekhimar Department of Otorhinolaryngology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
  • Sayed Mohamed Saied Kadah Department of Otorhinolaryngology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
  • Soad Yehia Mostafa Department of Otorhinolaryngology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt



Pediatric, Otitis media, Cochlear implant


Background: A cochlear implant (CI) is a greatly effective therapy for severe to profound deafness. This study aims to examine the prevalence of otitis media (OM) in children after CI and its impact on the device’s integrity with reporting the various management policies and results.

Methods: This retrospective cohort study included 307 children, aged one to five years, who had CIs performed by the surgical team between January 2016 and December 2019. A detailed pre, intra, and postoperative data collected from these patients’ medical records was reviewed retrospectively by the same surgical team.

Results: There is a statistically significant difference in the distribution of OM in the operated ears; the p value was <0.001. There is a statistically significant association between post-implant OM and getting implantation, as the p value was <0.001. Multivariate analysis showed significant associations between post-implant OM and a history of receiving vaccination (no), a perioperative history of otitis media with effusion (yes), and a history of recurrent tonsillitis and enlarged adenoids (yes) (p value< 0.05).

Conclusions: In children, the prevalence of developing post-implant OM in the implanted ears does not rise, but rather falls, contradicting the theory that foreign bodies may aggravate the infection. Our findings supported the safety of CI in children with a history of post-implant OM, as all cases of post-implant OM were managed medically, with no additional surgical intervention required. Furthermore, no case had any significant complications, such as meningitis, or had a negative impact on the device's integrity.


Parisier SC, Chute P. Cochlear implants: indications and technology. Med Clin North Am. 1991;75:1267-76.

Sampaio AL, Araújo MF, Oliveira CA. New criteria of indication and selection of patients to cochlear implant. Int J Otolaryngol. 2011;2011:573968.

Szyfter W, Karlik M, Sekula A, Harris S, Gawęcki W. Current indications for cochlear implantation in adults and children. Otolaryngol Pol. 2019;73:1-5.

Black IG, Bailey C, Albert D, Leighton S, Hartley B, Chatrath P, et al. The Great Ormond Street Hospital paediatric cochlear implant programme 1992-2004 A review of surgical complications. Cochlear Implants Int. 2007;8:53-67.

Venail F, Sicard M, Piron JP, Levi A, Artieres F, Uziel A, et al. Reliability and complications of 500 consecutive cochlear implantations. Arch Otolaryngol Head Neck Surg. 2008;134:1276-81.

Bhatia K, Gibbin KP, Nikolopoulos TP, O'Donoghue GM. Surgical Complications and Their Management in a Series of 300 Consecutive Pediatric Cochlear Implantations. Otol Neurotol. 2004;25:730-9.

Tambyraja RR, Gutman MA, Megerian CA. Cochlear implant complications: utility of federal database in systematic analysis. Arch Otolaryngol Head Neck Surg. 2005;131:245-50.

Chung D, Kim AH, Parisier S, Linstrom C, Alexiades G, Hoffman R, et al. Revision cochlear implant surgery in patients with suspected soft failures. Otol Neurotol. 2010;31:1194-8.

Balkany TJ, Hodges AV, Buchman CA, Luxford WM, Pillsbury CH, Roland PS, et al. Cochlear implant soft failures consensus development conference statement. Cochlear Implants Int. 2005;6:105-22.

Dhooge I. Acute Otitis Media in Children. Pediatric ENT. 2007;3:399-411.

Grant GD, Cheng AK, Niparko JK. Meta-Analysis of Pediatric Cochlear Implant Literature. Ann Otol Rhinol Laryngol. 1999;108:124-8.

Egilmez OK, Kalcioglu MT. Genetics of nonsyndromic congenital hearing loss. Scientifica (Cairo). 2016;2016:7576064.

Migirov L, Yakirevitch A, Kronenberg J. Surgical and medical complications following cochlear implantation: comparison of two surgical approaches. ORL J Otorhinolaryngol Relat Spec. 2006;68:213-9.

Luntz M, Teszler CB, Shpak T. Cochlear implantation in children with otitis media: second stage of a long-term prospective study. Int J Pediatr Otorhinolaryngol. 2004;68:273-80.

Kaur R, Morris M, Pichichero ME. Epidemiology of Acute otitis media in the postpneumococcal conjugate vaccine era. Pediatrics. 2017;140.

Van Dyke MK, Pirçon JY, Cohen R, Madhi SA, Rosenblüt A, Macias Parra M, et al. Etiology of acute otitis media in children less than 5 years of age: a pooled analysis of 10 similarly designed observational studies. Pediatr Infect Dis J. 2017;36:274-81.

Vila PM, Ghogomu NT, Odom-John AR, Hullar TE, Hirose K. Infectious complications of pediatric cochlear implants are highly influenced by otitis media. Int J Pediatr Otorhinolaryngol. 2017;97:76-82.

Raveh E, Ulanovski D, Attias J, Shkedy Y, Sokolov M. Acute mastoiditis in children with a cochlear implant. Int J Pediatr Otorhinolaryngol. 2016;81:80-3.

Danishyar A, Ashurst JV. Acute Otitis Media. Treasure Island (FL): StatPearls Publishing. 2022.

Okur E, Yildirim I, Akif Kilic M, Guzelsoy S. Prevalence of otitis media with effusion among primary school children in Kahramanmaras, in Turkey. Int J Pediatr Otorhinolaryngol. 2004;68:557-62.

Alho OP, Oja H, Koivu M, Sorri M. Chronic otitis media with effusion in infancy. How frequent is it? How does it develop? Arch Otolaryngol Head Neck Surg. 1995;121:432-6.

Britt AF, Poupore NS, Nguyen SA, White DR. Improving pneumococcal vaccination rates in cochlear implant programs: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2022;194.

Jin L, Téllez P, Chia R, Lu D, Chadha NK, Pauwels J, et al. Improving vaccination uptake in pediatric Cochlear implant recipients. J Otolaryngol Head Neck Surg. 2018;47:56.

Piotrowska A, Paradowska-Stankiewicz I, Skarżyński H. Rates of vaccination against streptococcus pneumoniae in cochlear implant patients. Med Sci Monit. 2017;23:4567-73.

Choo S, Finn A. New pneumococcal vaccines for children. Arch Dis Child. 2001;84:289-94.

Ozgur SK, Beyazova U, Kemaloglu YK, Maral I, Sahin F, Camurdan AD, et al. Effectiveness of inactivated influenza vaccine for prevention of otitis media in children. Pediatr Infect Dis J. 2006;25:401-4.






Original Research Articles