Cochlear implantation in postmeningitic deafness

Abstract

Objectives/hypothesis: To propose guidelines in the management of a profound bilateral sensorineural hearing loss after bacterial meningitis.

Study design: Retrospective chart review.

Patients: All 40 postmeningitic cochlear implantation surgeries performed between August 1987 and April 2007.

Methods: Descriptive analysis of data on the cause of meningitis, preoperative imaging evaluation, age at implantation, time elapsed between meningitis and implantation, and relevant surgical findings.

Results: Twenty-seven children and 13 adults with postmeningitic deafness were implanted. Mean age was 3 years 8 months for the children and 44 years and 10 months for the adults. The mean time delay between meningitis and surgery was 2 years 1 month for children and 28 years for adults. Eighteen children (67%) were implanted within a year. Labyrinthitis ossificans was evidenced at surgery in 62% of patients. Intraoperative cochlear ossification was classified according to the scale described by Smullen and Balkany (2005). Stage II ossification was seen in 3 patients within 49 days, with 1 of them as soon as 21 days. There was a partial insertion in 9 patients secondary to ossification. Open-set speech discrimination was achieved by 37% of the children (10 of 27) and 23% of the adults (3 of 13).

Conclusion: We recommend early cochlear implantation for patients with bilateral profound deafness secondary to meningitis.