Hematoma After 15 Years Cochlear Implantation: A Rare Case Report

Objective: Cochlear implantation (CI) is a safe procedure. Complications are rare but it can be fetal such as meningitis. Hematoma following CI is uncommon with prevalence of 0.9%. To best of our knowledge only few cases reported in English journal pertaining to hematoma following CI.

Case Presentation: We present an 18 years old lady with bilateral congenital profound sensorineural hearing loss. She had unilateral CI at age of three. She presented with acute onset recurrent painful swelling at receiver site fifteen years post CI. There is no significant otological finding on examination. Ultrasonography showed anechoic collection superficial to cochlear implant. She was treated with intravenous antibiotic and compression mastoid bandage. She had clinical improvement and was discharged. However swelling recurred. She was immediately admitted and had needle aspiration under ultrasound guidance with application of compression mastoid bandage subsequently.

Conclusion: Hematoma post CI has varying time frame in its development, as early as days up to years due to multiple etiologies such as trauma, coagulopathy, and idiopathic cause. A prompt recognition and treatment must be instituted to prevent further complications. We recommend longer use of mastoid compression bandage for 48-72 hours in adjunct with needle aspiration under ultrasound guided.