Subcutaneous emphysema around the cochlear implant: Two distinct etiologies

Subcutaneous emphysema is usually induced by trauma, infection with gas-forming organisms, or surgical interventions. Few cases have been reported with subcutaneous emphysema after cochlear implantation. Here, we present two cases of subcutaneous emphysema with two distinct etiologies. One case presented with recurrent, bilateral, self-limiting, and mild swelling around the internal receiver stimulator of the cochlear implant. In-depth history taking of this patient revealed that each episode of this swelling was preceded by an upper respiratory tract infection, associated with forceful sneezing and coughing. This patient was managed conservatively. The other case had a long history of otorrhea, for which he did not seek medical attention. The patient presented with painful swelling over the internal receiver stimulator. Moreover, the underlying cause of the subcutaneous emphysema was found to be a cholesteatoma. This patient was managed surgically with the preservation of the device.