Biofilm in Cochlear Implant: A Surgeon’s Diagnosis

Biofilms in a cochlear implant can lead to severe intracranial complications like meningitis, and it can cause implant failure, thus requiring an explant, leading to financial and social loss. Meticulous sterility in the intraoperative period and proper hygiene in the postoperative period need to be emphasized in a cochlear implant Patient. We report a case of a 4-year-old girl child who presented with recurrent episodes of wound dehiscence through the cochlear implant site following the asymptomatic period after a course of antibiotics, and finally treated with debridement and flap reconstruction under general anaesthesia. We sought to use novel agents with antimicrobial activity in addition to debridement, vascularized soft tissue cover, and oral rifampicin after surgery. The child underwent serial surgeries, and finally, the use of medical grade Manuka honey and rifampicin demonstrated a successful response to biofilm up to a two-month follow-up period. This case revealed that biofilm is primarily a surgeon’s diagnosis.