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Rapidly progressive bilateral postmeningitic deafness in children: Diagnosis and management

A De Barros1, T Roy1, I Amstutz Montadert1

  • 1Service d'ORL et de chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU, rue de Germont, 76031 Rouen, France.

European Annals of Otorhinolaryngology, Head and Neck Diseases
|February 25, 2014
PubMed

Insights

Severe bilateral deafness can follow meningitis. Early diagnosis via audiology and Auditory Brainstem Response testing, followed by urgent MRI, is crucial. Bilateral cochlear implantation is recommended for ossification.

Area of Science:

  • Otolaryngology
  • Neurology
  • Pediatrics

Background:

  • Bacterial meningitis can lead to severe or profound bilateral deafness.
  • The onset of deafness can be immediate or delayed by several months post-meningitis.
  • Early diagnosis and intervention are critical for managing post-meningitic hearing loss.

Purpose of the Study:

  • To establish a diagnostic pathway for severe or profound bilateral deafness after meningitis.
  • To propose evidence-based management guidelines for affected patients.
  • To evaluate the role of imaging and audiological tests in diagnosing and managing this condition.

Main Methods:

  • Retrospective review of five patients (infants and adolescents) with post-meningitic deafness.
  • Audiometry, Behavioral Audiological Testing, and Auditory Brainstem Response (ABR) tests were used for diagnosis.
  • Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) were performed to assess cochlear changes.

Main Results:

  • Deafness was diagnosed an average of 68.8 days after meningitis.
  • MRI revealed endolymph changes in four patients; CT showed ossification in one.
  • All five patients underwent bilateral cochlear implantation, with good outcomes in four cases.

Conclusions:

  • Bilateral deafness post-meningitis requires prompt diagnostic evaluation, including audiological testing and MRI.
  • Urgent MRI is essential to identify endolymph inflammation or ossification.
  • Early bilateral cochlear implantation is recommended, especially when ossification is present.
Abstract

Keywords:
Acquired deafnessChildrenCochlear implantMeningitis

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