Infected cochlear implant after large-volume nasal irrigation.

Objective: A patient with a well-healed, functional cochlear implant (CI) experienced a CI and mastoid infection shortly after initiating large-volume nasal irrigations after sinus surgery. The goal of this report is to bring attention to a rare complication and to question if large-volume nasal irrigation is safe in CI recipients.
Patients: Single patient at a tertiary care hospital.
Interventions: A CI recipient began using large-volume nasal irrigations with saline and budesonide after undergoing sinus surgery.
Main Outcome Measures: CI infection and mastoiditis.
Results: Two weeks after starting nasal irrigations, the patient presented with mastoiditis and CI infection. Mastoid and intranasal middle meatal cultures both grew Group A streptococcus.
Conclusion: Large-volume nasal irrigations may be related to our patient's CI infection, ultimately leading to explantation. Though a causal relationship cannot be definitively proven, awareness of this potential safety issue should be disseminated.