Outcomes of Cochlear Implantation in Postmeningitis Hearing Loss: A Systematic Review and Meta-Analysis

Abstract

Background: Cochlear implantation (CI) has revolutionized auditory rehabilitation for patients with severe to profound hearing loss secondary to bacterial meningitis. This systematic review synthesizes current evidence on CI outcomes in this patient population. Demographic characteristics, surgical techniques, and audiometric outcomes across studies published from 1993 to 2024 are highlighted.

Methodology: In a systematic search of electronic databases, 19 eligible studies from Europe, North America, China, and Turkey were identified. These studies included retrospective cohort designs, prospective cohorts, and case series that assessed various aspects of CI outcomes. Data extraction was focused on patient demographics, preimplantation characteristics, surgical details, and postoperative outcomes.

Results: The studies reported heterogeneous but positive audiological outcomes following CI. Significant improvements in speech perception and quality-of-life metrics were observed across different patient subgroups. This review identified variability in surgical approaches (eg, cochleostomy and circumodiolar drill-out), implant devices (eg, nucleus and advanced bionics), and speech processing strategies (eg, SPEAK and ACE). Audiological gains were influenced by factors such as age at implantation, duration of deafness, and presence of cochlear ossification.

Conclusion: CI offers significant benefits for patients with postmeningitis hearing loss, although the outcomes vary based on patient-specific factors and surgical techniques. The findings from this review underscore the importance of personalized treatment approaches and highlight areas for future research, including standardized outcome measures and long-term follow-up, to optimize patient outcomes and refine clinical protocols.

Keywords: cochlear implantation; hearing assessment; hearing loss; meningitis.