Cochlear implant site infection and extrusion. How I manage it?

Cochlear implant site infection and/or skin extrusion remain challenging issues in cochlear implant field. Staged procedures with implant removal is the standard treatment in most of cochlear implant centers. However, in many areas, this may be very difficult due to budget restrain. In this paper, I'm going to present our personal experiences in managing those cases without removal of the implant. We had total of 6 cases of either postoperative infection with skin breakdown or skin breakdown over the implant with infection. We could treat 5 cases without removal of the implant. The key steps are covering the implant with skin flap together with use of local antibiotic powders over the implant (in the 5 cases we used vancomycin powder). The failure case in which we had to remove the implant had vancomycin hypersensitivity. We believe that there is a chance with this technique to treat implant site infection and biofilm formation without removal of the implant with high success rate. [ABSTRACT FROM AUTHOR]