Learning objectives: to determine the incidence of chronic otitis media in pediatric implantees and to define influencing factors.

Introduction: COM is considered a late sequela of both recurrent AOM and also of ventilating tubes. In children with a cochlear implant, the risks of middle ear infection and its potential spread along the electrode array into the cochlea and central nervous system are relatively high, mandating an aggressive management including insertion of ventilating tubes. Although the rate of AOM episodes diminishes after cochlear implantation, it remains high in otitis media (OM) prone children, thus might lead to repeated ventilating tube (VT) insertions. Information regarding the incidence of COM in children after cochlear implantation is scarce. The aim of the study is to determine the incidence of COM in pediatric implantees and to define influencing factors.

Methods: A retrospective study including 200 pediatric implantees. Mean age at CI was 32.58 ± 17.83 months and mean post-operative follow-up was 72.41 ± 35.27 months. Management was based on a structured AOM control protocol.

Results: 126 children (63%) were classified as OM prone and 74 (27%) as non-OM prone. 38 children (19%) underwent ≥ 2 VT insertions. Chronic OM developed in 15 children (7.5%). Seven children had a tympanic membrane perforation, 7 had adhesive middle ear disease and one more had cholesteatoma. Myringosclerosis appeared in 22 children (11%).

Discussion: Children after cochlear implantation continue to suffer from sequela of recurrent episodes of AOM. Significantly more myringosclerosis is found in OM-prone children who underwent repeated VT insertions. These children are also at increased risk for development of COM. OM-prone implantees should be followed carefully and continuously for early diagnosis and surgical intervention in cases of COM.