Cochlear implantation in postmeningitic deafness.

OBJECTIVES/HYPOTHESIS: To propose guidelines in the management of a profound bilateral sensorineural hearing loss after bacterial meningitis.

STUDY

DESIGN

Retrospective chart review.

PATIENTS: All 40 postmeningitic cochlear implantation surgeries performed between August 1987 and April 2007.

METHODS

Descriptive analysis of data on the cause of meningitis, preoperative imaging evaluation, age at implantation, time elapsed between meningitis and implantation, and relevant surgical findings.

RESULTS

Twenty-seven children and 13 adults with postmeningitic deafness were implanted. Mean age was 3 years 8 months for the children and 44 years and 10 months for the adults. The mean time delay between meningitis and surgery was 2 years 1 month for children and 28 years for adults. Eighteen children (67%) were implanted within a year. Labyrinthitis ossificans was evidenced at surgery in 62% of patients. Intraoperative cochlear ossification was classified according to the scale described by Smullen and Balkany (2005). Stage II ossification was seen in 3 patients within 49 days, with 1 of them as soon as 21 days. There was a partial insertion in 9 patients secondary to ossification. Open-set speech discrimination was achieved by 37% of the children (10 of 27) and 23% of the adults (3 of 13).

CONCLUSION

We recommend early cochlear implantation for patients with bilateral profound deafness secondary to meningitis.