Hearing impairment after bacterial meningitis: a review.

Fortnum, Heather

doi:10.1136/adc.67.9.1128

Cited by 159 publications

(110 citation statements)

References 56 publications

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“…• Some children will have no impairment at birth, but will acquire the impairment later in their life as a result of some traumatic event such as infection (usually bacterial meningitis, Fortnum, 1992), head injury (Zimmerman et al, 1993), ototoxic therapy (Casano et al, 1999) or chemotherapy (Littman et al, 1998;Berg et al, 1999). …”

Section: (I)mentioning

confidence: 99%

Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen

Bamford¹,

Fortnum²,

Bristow³

et al. 2007

Health Technol Assess

122

153

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Section: (I)mentioning

confidence: 99%

Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen

Bamford¹,

Fortnum²,

Bristow³

et al. 2007

Health Technol Assess

122

153

View full text Add to dashboard Cite

show abstract

“…No adjuvant medication abated this effect, not even if the data were sorted agentwise or according to the timing of antimicrobial therapy. Thus, the experience [8][9][10] (albeit not demonstrated by this study) that pneumococcal meningitis in survivors is more deletorious to the hearing organ than other meningitides, seems to be more associated with the patient's frequently poor clinical condition in this type of meningitis 29 than with the agent per se-as such an interesting finding.…”

Section: Discussionmentioning

confidence: 66%

“…[6][7][8] Overall, impairment is reported in 30% to 50% in pneumococcal, in 10% to 30% in Hib, and in 5% to 25% in meningococcal meningitis. [9][10][11][12][13] Almost certainly these estimates are too low, [13][14][15][16][17] because most data arrive from the best centers. Worldwide, most survivors are discharged without reliable information on hearing.…”

mentioning

confidence: 99%

Hearing Impairment in Childhood Bacterial Meningitis Is Little Relieved by Dexamethasone or Glycerol

et al. 2010

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WHAT'S KNOWN ON THIS SUBJECT:Adjuvant dexamethsasone is believed to prevent or relieve hearing impairment, especially in Hib meningitis if instituted before antimicrobial treatment, but no single study has documented this effect. All information derives from metaanalyses in which profoundly different populations have been combined. WHAT THIS STUDY ADDS:This randomized, double-blind clinical trial, the largest in pediatrics, revealed no significant relief in hearing impairment by adjuvant intravenous dexamethsone, oral glycerol, or their combination. Instead, the child's presenting status and age were the most important predictors of hearing loss. abstract OBJECTIVE. Several studies have evaluated dexamethasone for prevention of hearing loss in childhood bacterial meningitis, but results have varied. We compared dexamethasone and/or glycerol recipients with placebo recipients, and measured hearing at 3 threshold levels. METHODS. Children aged 2 months to 16 years with meningitis were treated with ceftriaxone but were double-blindly randomly assigned to receive adjuvant dexamethasone intravenously, glycerol orally, both agents, or neither agent. We used the Glasgow coma scale to grade the presenting status. The end points were the better ear's ability to detect sounds of Ͼ40 dB, Ն60 dB, and Ն80 dB, with these thresholds indicating any, moderate-to-severe, or severe impairment, respectively. All tests were interpreted by an external audiologist. Influence of covariates in the treatment groups was examined by binary logistic regression. RESULTS: Of the 383 children, mostly with meningitis caused by Haemophilus influenzae type b or Streptococcus pneumoniae, 101 received dexamethasone, 95 received dexamethasone and glycerol, 92 received glycerol, and 95 received placebo. Only the presenting condition and young age predicted impairment independently through all threshold levels. Each lowering point in the Glasgow scale increased the risk by 15% to 21% (odds ratio: 1.20, 1.21, and 1.15 [95% confidence interval: 1.06 -1.35, 1.07-1.37, and 1.01-1.31]; P ϭ .005, .003, and .039) for any, moderate-to-severe, or severe impairment, respectively. Each increasing month of age decreased the risk by 2% to 6% (P ϭ .0001, .0007, and .041, respectively). Neither dexamethasone nor glycerol prevented hearing loss at these levels regardless of the causative agent or timing of antimicrobial agent. CONCLUSIONS: With bacterial meningitis, the child's presenting status and young age are the most important predictors of hearing impairment. Little relief is obtained from current adjuvant medications.

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“…The incidence of meningitis induced hearing loss is diVerent for varying causative agents such as S. pneumoniae (31-36%), N. meningitidis (8-11%) and H. inXuenza (6-11%) [1][2][3]. Meningitis induced hearing loss is probably the result of the spread of infection to the inner ear via the cochlear aqueduct or modiolus and develops at an early stage of meningitis.…”

Section: Introductionmentioning

confidence: 99%

“…Bacterial meningitis is an infamous cause of acquired hearing loss leading to profound bilateral hearing loss in up to 4% of those aVected [1,2]. The incidence of meningitis induced hearing loss is diVerent for varying causative agents such as S. pneumoniae (31-36%), N. meningitidis (8-11%) and H. inXuenza (6-11%) [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Erratum to: Magnetic resonance imaging in patients with meningitis induced hearing loss

Beijen

Casselman²,

Joosten³

et al. 2009

Eur Arch Otorhinolaryngol

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The aim of this multicentre study was to compare T1 with T2 weighted MRI scans of the labyrinth after meningitis and to investigate whether waiting with scanning improved the reliability of diagnosing an ongoing process such as cochlear osteogenesis. Forty-Wve patients were included who suVered from meningitis induced hearing loss (radiological imaging <1 year after meningitis). Twentyone gadolinium enhanced T1 and 45 T2 weighted MRI scans were scored by two radiologists regarding the condition of the labyrinth. These radiological observations were compared with the condition of the cochlea as described during cochlear implantation. A higher percentage of agreement with surgery was found for T2 (both radiologists 73%) than for T1 weighted MRI scans (radiologist 1: 62%, radiologist 2: 67%), but this diVerence is not signiWcant. There was no signiWcant diVerence between early (0-3 months) and late (>3 months) scanning, showing that radiological imaging soon after meningitis allows early diagnosis without suVering from a lower agreement with surgical Wndings.

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Hearing impairment after bacterial meningitis: a review.

Cited by 159 publications

References 56 publications

Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen

Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen

Hearing Impairment in Childhood Bacterial Meningitis Is Little Relieved by Dexamethasone or Glycerol

Erratum to: Magnetic resonance imaging in patients with meningitis induced hearing loss

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