Five patients presented with infection and an exposed cochlear implant and we decided to salvage them by attempting use of new antimicrobial treatment for biofilms using betaine surfactant and polyhexanide along with wound debridement and double layered vascularized flap. This is the first study demonstrating the use of betaine surfactant and polyhexanide in the management of biofilm in cochlear implants and we could salvage four infected cochlear implants by the aforementioned method. Early intervention can significantly improve salvage outcomes in cochlear implants infected with biofilms.