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Long-term effects of dexamethasone on hearing ability in children with pneumococcal meningitis
Metehan Ozen1, Güler Kanra, Ateş Kara
1Infectious Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Adjuvant dexamethasone therapy in bacterial meningitis did not significantly impact hearing outcomes. However, it may help prevent serious sensorineural hearing impairment in patients with pneumococcal meningitis.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- Bacterial meningitis can lead to hearing impairment.
- The role of adjuvant dexamethasone therapy in mitigating hearing loss remains unclear.
Purpose of the Study:
- To investigate long-term hearing outcomes in pneumococcal meningitis survivors.
- To assess the effect of adjuvant dexamethasone therapy on hearing ability.
Main Methods:
- Retrospective study of 55 patients with pneumococcal meningitis (1987-1997).
- Patients divided into two groups: those who received dexamethasone and those who did not.
- Pure tone threshold estimation used to assess hearing ability.
Main Results:
- Overall, 20% of patients developed sensorineural hearing impairment (SNHI).
- No statistically significant difference in SNHI rates between groups (24% without dexamethasone vs. 16% with dexamethasone).
- Dexamethasone group had only minimal-borderline SNHI, while the non-dexamethasone group included two cases of moderate-serious SNHI.
Conclusions:
- Adjuvant dexamethasone therapy showed no statistically significant impact on overall hearing ability after pneumococcal meningitis.
- Dexamethasone may be beneficial in preventing severe sensorineural hearing impairment.
Abstract:
Controlled trials concerning adjuvant dexamethasone therapy in bacterial meningitis do not point unequivocally to a beneficial effect on hearing ability. We investigated the remote adverse outcomes of pneumococcal meningitis and, if any, beneficial effects of adjuvant dexamethasone therapy on hearing ability. Fifty-five subjects who experienced pneumococcal meningitis between 1987-97 were divided into two groups as 25 subjects who did not receive dexamethasone (Group 1) and the remaining 30 subjects who did (Group 2). All subjects underwent pure tone thresholds estimation. There were a total of 11 subjects (20%) with sensorineural hearing impairment (SNHI): 6 in the first group (24%) and 5 in the second group (16%). Although there was no statistically significant difference in the SNHI ratio between the groups, all the subjects who used adjuvant dexamethasone therapy suffered only minimal-borderline SNHI, whereas 2 patients in Group 1 had moderate-serious SNHI. Even though adjuvant dexamethasone therapy had no statistically significant impact on hearing ability after long-term follow-up, its use may be a good choice in terms of preventing serious SNHI.
