Predisposing factors, outcomes, and treatment approach to fluid gusher complication during cochlear implant surgery

Our research focused on the fluid gusher complication from cochlear implant surgery. Fluid gusher is one of the most prevalent complications of cochlear implant surgery and occurs when cerebral spinal fluid leaks from the cochleostomy site. The complication occurs with opening the round window. We performed a systematic review of the literature, focusing on overviews of cochlear implant surgery complications. There are many factors contributing to the cause of fluid gushers including, biological sex, age, time of procedure, follow up time, temporal bone abnormalities, and abnormalities of the lateral wall of the internal auditory canal. Fluid gusher puts some patients at a higher risk of developing postoperative meningitis. Treatment includes elevating the patient’s head to reduce intracranial pressure, and packing the cochleostomy/round window. Closing the cochleostomy with temporalis fascia, muscle, connective tissue, or fibrin glue in addition to intravenous 20% mannitol drip was the most frequently reported management approach. We hope continued research will develop a mainstay treatment approach for fluid gusher complications, as there is no standardized treatment protocol currently put in place.