Contralateral Implantation in Children Affected by Postimplant Meningitis

Abstract

This study was designed to investigate the indication and advantages of contralateral implantation after postimplant meningitis (piM). Speech perception assessment, most comfortable levels and high-resolution computer tomography were used to monitor cochlear fibrosis/ossification and clinical changes in outcomes in 5 children affected by meningitis after a variable-time post-cochlear implantation. Ipsilateral ossification was found in 3 children, 1 of whom developed delayed contralateral ossification. These children were implanted on the contralateral side as they all showed deterioration of hearing performance. Results from the present paper and literature analysis suggest that, (1) piM can induce ipsilateral and contralateral ossification, (2) meningitis-induced cochlear ossification is more prone to develop in the presence of a normal cochlear structure and (3) contralateral implantation after piM has proven to be effective in restoring performance when a full electrode insertion is accomplished.

Meningitis post-cochlear implant and role of vaccination

“…3 It has been reported that CI may carry a higher risk of bacterial meningitis in comparison with the general population. [4][5][6][7][8] In 2002, the United States Food and Drug Administration released a notification of receiving several reports, indicating a potential correlation between CI and the incidence of bacterial meningitis. 9 Bacterial meningitis is a critical illness with remarkable morbidity and mortality rates.…”

“…Several risk factors may contribute to meningitis in CI users, including otitis media, head trauma, cochlear malformations, and cerebrospinal fluid (CSF) leaks. [4][5][6][7][8] The clinical features of post-CI meningitis do not differ from those of classical meningitis which include high temperature, headache, neck stiffness, photophobia, sickness, and vomiting. However, CI users may experience further complaints such as vertigo.…”

“…A total of 32 studies published between 1991 and 2020 and 27358 patients were included. [4][5][6]8,10, Seventeen were case studies while 15 were retrospective observational studies. Most of the studies (37.5%) were carried out in the United States.…”