To propose guidelines in the management of a profound bilateral sensorineural hearing loss after bacterial meningitis.
Retrospective chart review.
All 40 postmeningitic cochlear implantation surgeries performed between August 1987 and April 2007.
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.
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).
We recommend early cochlear implantation for patients with bilateral profound deafness secondary to meningitis.
Département d'otorhinolaryngologie et de chirurgie cervico-faciale, Hôtel-Dieu-de-Québec du Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
Address correspondence and reprint requests to Daniel Philippon, D.M.D., M.D., Hôtel-Dieu de Québec, 11, côte du Palais, Québec, Canada G1R 2J6; E-mail: email@example.com
Presented at the 61st Annual Meeting of the Canadian Society of Otolaryngology Head & Neck Surgery held in Montreal, Quebec, Canada, May 13-16, 2007.