Cochlear implantation in chronic suppurative otitis media

Patients with chronic serous or suppurative otitis media (CSOM) requiring cochlear implantation present a management challenge. Treatment protocols are emerging for cochlear implantation in CSOM. Elimination of infection and protection of the cochlear implant electrode array are the principle goals, although prevention of infection, including the potential for intracranial involvement, takes precedence over early implantation. In some cases of active disease, a staged procedure may be required. Here, we review the literature, discuss management of cochlear implantation in CSOM, and provide a management algorithm to guide decision-making.