Cochlear Implantation after Bacterial Meningitis in Infants Younger Than 9 Months

Abstract

Objective. To describe the audiological, anesthesiological, and surgical key points of cochlear implantation after bacterial meningitis in very young infants. Material and Methods. Between 2005 and 2010, 4 patients received 7 cochlear implants before the age of 9 months (range 4–8 months) because of profound hearing loss after pneumococcal meningitis. Results. Full electrode insertions were achieved in all operated ears. The audiological and linguistic outcome varied considerably, with categories of auditory performance (CAP) scores between 3 and 6, and speech intelligibility rating (SIR) scores between 0 and 5. The audiological, anesthesiological, and surgical issues that apply in this patient group are discussed. Conclusion. Cochlear implantation in very young postmeningitic infants is challenging due to their young age, sequelae of meningitis, and the risk of cochlear obliteration. A swift diagnostic workup is essential, specific audiological, anesthesiological, and surgical considerations apply, and the outcome is variable even in successful implantations.

Delayed cochlear implantation in post-meningitic deafness and hereditary complement C2 deficiency

“…This is a well-known phenomenon, related with the reduced survival rate of spiral ganglion cells in postmeningitic cochleas. [28][29][30] The personal experience with CIs after long-term deprivation was also quite disappointing: in agreement with the literature [31][32][33], none of our pre-verbal children receiving a CI after 10 years of age ever equalled the speech perception performances of earlier CI recipients (below 3 years of age at surgery).…”

Early Intervention for Hearing Impaired Children. Istanbul, Turkey, May 21-22, 2013: Abstracts

“…Finally, fixation of the electrode in the inferior mastoid tip is not advisable as the distance to the round window will increase substantially with temporal bone growth. Taking these considerations into account, which are increasingly important the younger the infant, we did not observe any peri or postoperative complications in these children under 9 months [Roukema et al, 2011].…”

“…The specific surgical issues to be taken into consideration for these very young patients are discussed [Roukema et al, 2011].…”

“…If severe SNHL occurs following bacterial meningitis, the credo for cochlear implantation should be: 'the sooner the better' . In any case, several surgical and anaesthesiological considerations need to be taken into account when implanting patients under the age of nine months [Roukema et al, 2011].…”

Cochlear implants and bacterial meningitis: A speech recognition study in paired samples

“…There is still no evidence that the meningitis causative agent is related to a better or worse prognosis. Additionally, with the analysis of more than 1600 cases of meningitis, it was found that there is no causative agent of meningitis that is more likely to cause LO, although there is a higher risk that Streptococcus pneumoniae meningitis may cause profound hearing loss 22 . Less populated spiral ganglions may be observed in such cases 12 .…”