Effects of Central Nervous System Residua on Cochlear Implant Results in Children Deafened by Meningitis

Abstract

Background: This study explored factors associated with speech recognition outcomes in postmeningitic deafness (PMD). The results of cochlear implantation may vary in children with PMD because of sequelae that extend beyond the auditory periphery. Objective: To determine which factors might be most determinative of outcome of cochlear implantation in children with PMD. Design: Retrospective chart review. Setting: A referral center for pediatric cochlear implantation and rehabilitation. Subjects: Thirty children with cochlear implants who were deafened by meningitis were matched with subjects who were deafened by other causes based on the age at diagnosis, age at cochlear implantation, age at which hearing aids were first used, and method of communication used at home or in the classroom. Main Outcome Measure: Speech perception performance within the first 2 years after cochlear implanta-tion and its relationship with presurgical cognitive measures and medical history. Results: There was no difference in the overall cognitive or postoperative speech perception performance between the children with PMD and those deafened by other causes. The presence of postmeningitic hydrocephalus, however, posed greater challenges to the rehabilitation process, as indicated by significantly smaller gains in speech perception and a predilection for behavioral problems. By comparison, cochlear scarring and incomplete electrode insertion had no impact on speech perception results. Conclusions: Although the results demonstrated no significant delay in cognitive or speech perception performance in the PMD group, central nervous system residua, when present, can impede the acquisition of speech perception with a cochlear implant. Central effects associated with PMD may thus impact language learning potential; cognitive and behavioral therapy should be considered in rehabilitative planning and in establishing expectations of outcome.

The Impact of Postmeningitic Labyrinthitis Ossificans on Speech Performance After Pediatric Cochlear Implantation

“…El-Kashlan et al (6) demonstrated that 24-month postimplant SPC in children with LO was significantly worse than matched patients with hearing loss secondary to congenital deafness. In contrast, Francis reported that LO had no significant impact on speech perception (7). Our study demonstrated a trend toward worse SPC outcomes and open-set speech recognition in patients with LO, but this was not found to be statistically significant.…”

A Comparison of Surgical Auditory Nerve Response and Speech Outcomes in Patients with Post-meningitic Deafness and Without Cochlear Osteogenesis Who Underwent Cochlear Implantation

“…Similar results were obtained by Francis et al [11] and Nikolopoulos et al [12] in children who underwent CI due to deafness resulting from meningitis compared to children with different causes of deafness. Another study in accordance with our conclusions on children but with longer follow-up for three years after CI surgery concluded that auditory capacity and speech performance were comparable in children with post-meningitic deafness and those undergoing implantation for other reasons [13].…”

Delayed cochlear implantation in post-meningitic deafness and hereditary complement C2 deficiency

“…This is a well-known phenomenon, related with the reduced survival rate of spiral ganglion cells in postmeningitic cochleas. [28][29][30] The personal experience with CIs after long-term deprivation was also quite disappointing: in agreement with the literature [31][32][33], none of our pre-verbal children receiving a CI after 10 years of age ever equalled the speech perception performances of earlier CI recipients (below 3 years of age at surgery).…”