Effects of central nervous system residua on cochlear implant results in children deafened by meningitis.
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.


METHODS
Retrospective chart review.


METHODS
A referral center for pediatric cochlear implantation and rehabilitation.


METHODS
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.


METHODS
Speech perception performance within the first 2 years after cochlear implantation 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.
Francis
Howard W
HW
Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, Baltimore, MD, USA. hfrancis@jhmi.edu
Pulsifer
Margaret B
MB
Chinnici
Jill
J
Nutt
Robert
R
Venick
Holly S
HS
Yeagle
Jennifer D
JD
Niparko
John K
JK
D002648:Child; D003052:Cochlear Aqueduct; D003054:Cochlear Implants; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008581:Meningitis / Q000150:complications*; D019986:Persons with Hearing Disabilities / Q000523:psychology* / Q000534:rehabilitation; D012189:Retrospective Studies; D013065:Speech Intelligibility; D013067:Speech Perception; D016896:Treatment Outcome