Author(s)
Varun V. Varadarajan MD
Patrick Antonelli MD
Affiliation(s)
University of Florida
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss the role of nuclear imaging techniques in the diagnosis of subclinical cochlear implant infections. Objectives: Indolent, low grade cochlear implant infections are challenging to diagnose and may present with only persistent, localized pain. We report a case of a low grade cochlear implant infection that was diagnosed using gallium-67 citrate single photon emission computerized tomography (Ga-SPECT) and review the literature describing the utility of Ga-SPECT in the diagnosis of cochlear implant infections. Study Design: Case report and literature review. Methods: The medical records of a patient with a cochlear implant infection diagnosed with Ga-SPECT were reviewed. A literature review was performed regarding the utility of nuclear imaging techniques in the diagnosis of cochlear implant infections. Results: A 7 year old male underwent right sided cochlear implantation for bilateral sensorineural hearing loss. Ten months after surgery, he developed pain at the implant site, refractory to empiric oral and parenteral antimicrobial therapy. Computerized tomography and technetium bone scans revealed no findings suggestive of soft tissue infection or osteomyelitis. Ga-SPECT demonstrated uptake at the base of the stimulator receiver. Findings upon explantation confirmed a low grade implant infection. Sequencing of DNA isolated from the implant revealed staphylococcus epidermidis. Pain resolved with explantation. Conclusions: This is the first reported case of a cochlear implant infection diagnosed solely with Ga-SPECT. Patients experiencing persistent pain around their cochlear implant with clinical suspicion for an underlying infection should undergo Ga-SPECT imaging.