INTRODUCTION:
The cochlear implant is considered to be a very effective and safe
surgical procedure that provides a world of sound to patients who are
rendered deaf or hard of hearing. Unfortunately, infections happen years
after implantation with dreaded cases of device exposure and poor
prognosis. One of the reasons for limited effectiveness of antibiotics
is the presence of biofilm on the device.1 Thus, the
knowledge of complications is essential to facilitate the best possible
early management and treatment especially flap related complications
such as hematoma, necrosis and infections. The percentage of infections
in cochlear implant patients range from 1.7% to 4.1%,2, 3 the severity of infections is difficult to
predict at that stage and can lead to device removal despite rigorous
medical and surgical efforts to eradicate the infection.
Biofilms are heterogeneous communities that are continuously changing.
The microorganisms synthesize and secrete a protective matrix that
attaches the biofilm firmly to a living surface. Any attempt at
conservative management would fail unless the eradication of biofilm
from the implant surface takes place. Recent literature supports the
role of tea tree oil and Hydrogen peroxide in eradicating
biofilm.4
Underlying bacterial infections and chronic inflammation leads to the
formation of biofilm. Because biofilms are found on the surface of many
medical devices, 5, 6 and also in infections in other
parts of body, we aimed at using new agents having antimicrobial
activity along with surgical debridement, double layer vascularised soft
tissue cover and using oral rifampicin post operatively.