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Published on: February 29, 2020
Cochlear implantation after bacterial meningitis in infants younger than 9 months
B Y Roukema1, M C Van Loon, C Smits
1Department of Otolaryngology and Head and Neck Surgery, VU University Medical Center Amsterdam, KNO ZH1D-116, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Insights
Cochlear implantation in infants after bacterial meningitis is challenging but feasible. Outcomes vary, requiring specialized audiological, anesthesiological, and surgical approaches for profound hearing loss.
Area of Science:
- Otolaryngology
- Pediatric Neurosurgery
- Infectious Diseases
Background:
- Bacterial meningitis can cause profound hearing loss in infants.
- Early cochlear implantation is crucial for auditory development in affected infants.
Purpose of the Study:
- To outline key audiological, anesthesiological, and surgical considerations for cochlear implantation in infants post-bacterial meningitis.
- To discuss the challenges and outcomes associated with this procedure in a very young population.
Main Methods:
- Retrospective analysis of 4 infants (4-8 months old) who received 7 cochlear implants between 2005-2010 after pneumococcal meningitis.
- Evaluation of audiological outcomes using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores.
Main Results:
- Successful full electrode insertion was achieved in all implanted ears.
- Auditory and linguistic outcomes showed considerable variability, with CAP scores ranging from 3 to 6 and SIR scores from 0 to 5.
- Specific audiological, anesthesiological, and surgical challenges were identified.
Conclusions:
- Cochlear implantation in very young infants following meningitis is complex due to age, disease sequelae, and risk of cochlear obliteration.
- A rapid diagnostic process and tailored management strategies are essential.
- Outcomes are variable despite successful implantation.
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.
