Meningitis post-cochlear implant and role of vaccination

To investigate the incidence, risk factors, and management of meningitis in cochlear implant (CI)users.

A systematic review was carried out using PubMed, Scopus, Web of Science, and Cochrane Central Register. Articles were considered relevant if reported any data on incidence, clinical presentations, the role of vaccination, management, and outcomes of meningitis after CI.

A total of 32 studies including 27358 patients were included, and meningitis was reported in only 202 cases. Meningitis occurred in the period ranging from 1 day to 72 months after CI. A total of 55 patients received the pneumococcal vaccine, while 20 patients received the Haemophilus influenzae type B vaccine. A large number of participants (n=47) had associated anatomical malformations, while 62 had otitis media before meningitis. A total of 24 cases required revision surgery along with medical treatment. Full recovery was the outcome reported by the included studies in 19 patients.

Cochlear implant users seem to be at possible risk of bacterial meningitis at any time after implantation, especially in the presence of risk factors, such as otitis media and anatomical malformations of the cochlea.