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Meningitis after cochlear implantation in Mondini malformation
1Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham 35233, USA.
Summary
Cerebrospinal fluid (CSF) leakage and meningitis can occur after cochlear implantation in malformed cochleas. This case highlights the importance of sealing cochleostomies to prevent delayed CSF otorhinorrhea and meningitis.
Area of Science:
- Otolaryngology
- Neurosurgery
- Pediatric Medicine
Background:
- Cochlear implantation is a common procedure for hearing restoration.
- Inner ear malformations, such as Mondini malformation, present unique surgical challenges.
- Cerebrospinal fluid (CSF) leakage and meningitis are recognized, albeit rare, risks following cochlear implantation.
Observation:
- A child with Mondini malformation experienced CSF otorhinorrhea and meningitis two years after cochlear implantation.
- The complication followed minor head trauma.
- CSF leakage was traced to the cochleostomy site surrounding the implant electrode.
Findings:
- The CSF leak was successfully sealed using a temporalis fascia and muscle plug.
- This case represents the first reported instance of delayed CSF otorhinorrhea and meningitis post-cochlear implantation in a patient with a malformed cochlea.
Implications:
- Thorough sealing of the cochleostomy during initial surgery is crucial in patients with inner ear malformations.
- Meningitis developing after cochlear implantation warrants investigation for potential CSF leakage from the labyrinth.
- This underscores the need for vigilance regarding potential long-term complications of cochlear implantation in complex cases.