Follow-up of cochlear implant use in patients who developed bacterial meningitis following cochlear implantation.
OBJECTIVE
The present study is a long-term follow-up of speech perception outcomes and cochlear implant use in three cases of meningitis that occurred after cochlear implantation.


METHODS
Case series study.


METHODS
Study was performed on three children implanted with different models of Clarion devices, two of them with positioner. Recognition and comprehension were assessed via the Italian adaptation of GASP (TAP) test, and phonetically balanced bi-syllabic words in open-set. High resolution computed tomography scan acquisition was performed to obtain axial coronal and oblique multiplanar reconstructions of the cochlea.


RESULTS
Two patients were affected by enlarged cochlear acqueduct and Mondini malformation the first carrying positioner. One patient had a normal cochlea, and the positioner could have been the main cause of bacterial spread. As a consequence of meningitis the child with normal cochlea and the other with enlarged vestibular acqueduct developed cochlear ossification, increased M-level and worsening of hearing outcomes. The child with Mondini malformation developed facial nerve stimulation. Contralateral implantation was performed in the first two patients.


CONCLUSIONS
Bacterial meningitis occurring after cochlear implantation may induce cochlear ossification, facial nerve stimulation, and permanent or temporary loss of implant use. Planned follow-up with high resolution computed tomography and evaluation of M-levels could be useful prognostic tools in the management of these patients.
Mancini
Patrizia
P
Dipartimento di Neurologia ed Otorinolaringoiatria, Universita di Roma La Sapienza, Rome, Italy. centroic@libero.it
D'Elia
Chiara
C
Bosco
Ersilia
E
De Seta
Elio
E
Panebianco
Valeria
V
Vergari
Valeria
V
Filipo
Roberto
R
D002648:Child; D002675:Child, Preschool; D003052:Cochlear Aqueduct / Q000002:abnormalities; D015834:Cochlear Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants / Q000009:adverse effects*; D003638:Deafness / Q000151:congenital / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000209:etiology; D012086:Reoperation; D013067:Speech Perception; D014057:Tomography, X-Ray Computed