POF and infection
The present study addresses the detailed post-operative course of CAM, following surgery. POF is a known entity in surgery in general and in ear surgery in particular. El-Saied et al . (12)reported an overall POF incidence of 19.2% after cochlear implant surgery and showed that POF was unrelated to infectious or local complications and did not seem to have any long-term significance. Nevertheless, in contrast to the AM cochlear implants is an elective and ”clean” procedure. In the setting of CAM; an acute infectious disease requiring surgery for purulent drainage and reduction of bacterial load, POF may be a sign of complications, requiring further investigation and treatment. To the best our knowledge our present study is the first to characterize the POF course of CAM. We found that POF is different in magnitude and behavioral patterns in SCG and in MCG. We found that in any given POD in the MCG, the fever tended to be more common and higher. However, around POD6, no differences were recorded in the values of fever measured between the two study groups, and the fever normalized in the majority of the patients. This is an important finding for clinicians, suggesting that in a patient with CAM (diagnosed either by preoperative imaging or intra-operative findings), POF should be expected and does not necessarily mean lack of control of the infection that would require repeated imaging and possibly revision surgery.