Audiological management in the recovery phase of bacterial meningitis

Smyth, Veronica; O'Connell, Berenice; Pitt, Robert; O’Callaghan, Michael; Scott, June

doi:10.1016/0165-5876(88)90053-5

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…In our series, changes in hearing loss were observed between 4 weeks and 8 months after meningitis. A systematic review has found earlier onset of hearing loss, which nevertheless often improved in the early phase of the meningitis ( 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

Repeated Audiometry After Bacterial Meningitis: Consequences for Future Management

Rodenburg-Vlot

Ruytjens²,

Oostenbrink³

et al. 2018

Otology &Amp; Neurotology

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Objective:Sensorineural hearing loss is a common sequela of bacterial meningitis. The objective of this study is to delineate the incidence and course of hearing loss after bacterial meningitis.Study Design:Retrospective cohort study.Setting:Tertiary referral center.Patients:Data of 655 patients who suffered from bacterial meningitis between 1985 and 2015 were analyzed.Interventions:None.Main Outcome Measurements:Availability of audiometric data, incidence of hearing loss, and onset and course of hearing loss.Results:In this cohort the incidence of hearing loss (>25 dB) was 28% (95% confidence interval 23–34%). The incidence of profound hearing loss (>80 dB) was 13% (95% confidence interval 10–18%). Normal hearing at the first assessment after treatment for meningitis remained stable over time in all these patients. In 19 of the 28 patients with diagnosed hearing loss, the hearing level remained stable over time. Hearing improved in six patients and deteriorated in two patients. One patient showed a fluctuating unilateral hearing loss.Conclusion:Audiological tests in patients with bacterial meningitis, especially children, should be started as soon as possible after the acute phase is over. As we found no deterioration of initial normal hearing after bacterial meningitis, repeated audiometry seems indicated only for those with diagnosed hearing loss at first assessment.

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Section: Discussionmentioning

confidence: 99%

Repeated Audiometry After Bacterial Meningitis: Consequences for Future Management

Rodenburg-Vlot

Ruytjens²,

Oostenbrink³

et al. 2018

Otology &Amp; Neurotology

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“…Guiscafre (1984) in his study on 236 children with meningitis, found HL in 16 per cent of patients in the acute phase of the disease and in 5.2 per cent of patients six months later. There are studies which report recovery of two thirds of the patients who had HL during the acute phase (Kotagal et al, 1981;Guiscafre et al, 1984;Brookhouser et al, 1988;Smyth et al, 1988). Some other studies reported that patients who had mild or moderate HL, usually totally recovered in time, while others who had no response in ABR initially, never recovered (Dodge et al, 1984;Brookhouser et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

“…Hearing loss in meningitis occurs through several mechanisms (Baldwin et al, 1985;Brookhouser etal, 1988;Harada et al, 1988;Smyth et al, 1988;Jiang et al, 1990;Bhatt et al, 1991;Fortnum, 1992): (1) Inflammation spreads from the subarachnoid space into the cochlear aqueduct or spreads through gaps inside the bones and leads to labyrinthitis. (2) The cause of the partial or temporary HL is toxic or serious labyrinthitis.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of hearing loss with auditory brainstem responses in the early and late period of bacterial meningitis in children

et al. 1997

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The hearing function of 50 children with bacterial meningitis was evaluated at the second and 10th days, and eight weeks after admission with auditory brain system responses (ABR) to investigate whether meningitis causes hearing loss. Normal values were obtained in all tests from both ears of 24 patients (48 per cent). Twelve patients (24 per cent) had temporary, and seven (14 per cent) patients had persistent mild degree hearing loss. Severe hearing loss was detected bilaterally in five (10 per cent) patients and unilaterally in two (four per cent) patients. Patients with other complications such as subdural effusion, convulsion, brain oedema and paralysis were found to have a higher incidence of hearing loss. We observed that patients treated with dexamethasone had 7.7 per cent persistent hearing loss, 11.6 per cent mild hearing loss, 34.6 per cent transient hearing loss, but in the group who did not receive dexamethasone there was 19.2 per cent persistent hearing loss, 15.3 per cent mild hearing loss and 11.6 per cent transient hearing loss. There were other signficant differences between the two groups in restoration of normal body temperature, the CSF/plasma glucose concentration ratio was elevated, CSF (cerebro-spinal fluid) protein concentration was decreased and the cell count in the CSF was decreased in the dexamethasone group, significantly more than the group who were not receiving dexamethasone. The hearing loss tended to be more frequent among younger children.

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“…Unfortunately these studies did not use tympanometry to detect or exclude OME so their conclusions should be interpreted with caution. In the one small study that did make use of impedance measurements, Smyth et al (1988) found that all cases of reversible hearing loss were associated with abnormal tympanograms. Our results are in agreement with this finding because the only children to regain normal hearing after discharge from hospital had conductive hearing loss.…”

Section: Discussionmentioning

confidence: 99%

Acute otitis media and otitis media with effusion in children with bacterial meningitis

et al. 1997

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Acute otitis media and otitis media with effusion (OME) have often been observed in children with bacterial meningitis. OME has also been proposed as the mechanism of reversible hearing loss after meningitis. In this controlled study, children with acute bacterial meningitis were studied using auditory brainstem responses (ABR), otoacousticemissions, tympanometry and otoscopy. An age- and sex- matched control was recruited for each patient and the incidence of acute otitis media and OME was compared between the twogroups. One hundred and twenty-four children with meningitis were studied. Ninety-two children (74 per cent) had meningococcal meningitis. Five patients (4 per cent) had conductive hearing loss (ABR threshold≥30 dB HL) at the time of discharge from hospital. None of the patients or controls had acute otitis media. Patients and controls were well matched for risk factors for OME and the prevalence of middle ear effusion in patients and controls was 7.2 per cent and 11.3 per cent respectively. The relative risk of OME in the children with meningitis was 0.64 (95 per cent confidence interval 0.29 to 1.42). After nine months, three of the five children with meningitis and conductive hearing loss had regained normal hearing.In contrast to previous reports, there was no relationship between bacterial meningitis and acute otitis media or OME in this study. Nevertheless, coincidental conductive hearing defects were identified as the cause of reversible hearing loss in three patients.

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Audiological management in the recovery phase of bacterial meningitis

Cited by 9 publications

References 6 publications

Repeated Audiometry After Bacterial Meningitis: Consequences for Future Management

Repeated Audiometry After Bacterial Meningitis: Consequences for Future Management

Evaluation of hearing loss with auditory brainstem responses in the early and late period of bacterial meningitis in children

Acute otitis media and otitis media with effusion in children with bacterial meningitis

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