Isolated vestibular ossification after meningitis associated with sensorineural hearing loss.
OBJECTIVE
Sensorineural hearing loss after bacterial meningitis is common. It is thought to be secondary to cochlear inflammation from direct bacterial seeding through the cochlear aqueduct. Although cochlear ossification with or without vestibular involvement is common, isolated vestibular ossification is rare. We review our recent experience with isolated vestibular ossification associated with profound sensorineural hearing loss and the implication for cochlear implantation in this population.


METHODS
Retrospective case review.


METHODS
Academic tertiary referral center.


METHODS
Patients referred with profound sensorineural hearing loss after bacterial meningitis with evidence of ossified vestibular labyrinth but normal cochleae on computed tomographic scanning were included in the study. INTERVENTIONS We review the history, imaging findings, operative intervention, and operative findings in this series of patients. MAIN OUTCOME MEASURES Clinical history, imaging findings, operative intervention, and operative findings.


RESULTS
Three patients with isolated vestibular ossification without computed tomographic evidence of cochlear osteoneogenesis were identified. Two of these patients subsequently underwent cochlear implantation with the Clarion device with complete insertion of the electrode array. Intraoperatively, one patient had isolated scala tympani ossification and the implant electrode array was placed within the scala vestibuli.


CONCLUSIONS
A pattern of sensorineural hearing loss and isolated ossification of the vestibular system without radiographic evidence of cochlear involvement may be seen after bacterial meningitis. In these patients, magnetic resonance imaging scanning should be performed, because computed tomographic scanning may not always detect cochlear ossification. Cochlear implantation is feasible in these patients.
Reeck
Jay B
JB
Division of Otology, Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California at San Francisco, San Francisco, California, USA.
Lalwani
Anil K
AK
D000328:Adult; D003054:Cochlear Implants; D006319:Hearing Loss, Sensorineural / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications*; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D015837:Vestibular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*