title: [Audiophonological evaluation of 16 children fitted with cochlear implants for sensorineural hearing loss induced by bacterial meningitis].
abstract: BACKGROUND
  Bacterial meningitis (BM) is the primary etiology of acquired sensorineural hearing loss (SNHL) in children and may compromise language development. Since the 1990 s, cochlear implants (CIs) have become part of the management of children with profound SNHL with encouraging results. The aim of this study was to analyze the audiophonological performance of children before and after cochlear implantation for SNHL following bacterial meningitis.
  
  
  METHODS
  Retrospective study of all children fitted with CIs for bilateral severe to profound SNHL after bacterial meningitis in the Robert-Debré pediatric ENT department between August 1990 and March 2009. Audiophonological performance was assessed using the APCEI profile.
  
  
  RESULTS
  Of the 283 children receiving implants during that period, 16 children (6%; 6 boys, 10 girls) underwent CI implantation after bacterial meningitis (Streptococcus pneumoniae in 8 cases, Neisseria meningitidis in 2 cases, and Haemophilus influenzae in 4 cases). The mean time from meningitis to SNHL was 8.3 months (median, 1.5 months; range, 1 day to 13 years). The mean time from meningitis to cochlear implantation was 2 years and 3 months (median, 7 months; range, 1 month to 13 years 3 months). Twelve children (75%) presented partial cochlear and/or vestibular ossification on presurgical CT scan. Three children received bilateral implants.
  
  
  CONCLUSIONS
  Thirteen children (81%) developed early SNHL in the first 3 months, whereas 3 children developed SNHL more than 10 months after meningitis. As for the benefits of cochlear implantation, 11 children presented near to normal intelligibility and optimal use of their cochlear implant; 5 children presented partial benefits due to neurological sequelae (1), a long delay before implantation (1), technical problems (2), or a social problem in relation to low socioeconomic status (1).
  
  
  CONCLUSIONS
  After bacterial meningitis, audiological evaluation must be made carefully during the first 3 months to detect early SNHL, but SNHL may also develop several years later. In case of profound SNHL and a modified signal of the labyrinth on the MRI, cochlear implantation must be performed without delay before cochlear and/or vestibular ossification. Cochlear implantation is an effective technique with good long-term audiologic results. The coexistence of neurological lesions may compromise the results, but it should not contraindicate a cochlear implantation.
authors.affiliation: Service d'ORL, université Paris Diderot, Sorbonne Paris Cité, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France. natacha.teissier@rdb.aphp.fr
authors.forename: N
authors.initials: N
authors.lastname: Teissier
authors.forename: I
authors.initials: I
authors.lastname: Doehring
authors.forename: N
authors.initials: N
authors.lastname: Noel-Petroff
authors.forename: M
authors.initials: M
authors.lastname: Elmaleh-Bergès
authors.forename: P
authors.initials: P
authors.lastname: Viala
authors.forename: M
authors.initials: M
authors.lastname: François
authors.forename: A
authors.initials: A
authors.lastname: Faye
authors.forename: T
authors.initials: T
authors.lastname: Van Den Abbeele
authors.forename: M
authors.initials: M
authors.lastname: Lorrot
mesh_terms: D002675:Child, Preschool; D015834:Cochlear Diseases / Q000209:etiology; D019929:Cochlear Implantation; D003054:Cochlear Implants; D032882:Comprehension / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications*; D008583:Meningitis, Haemophilus / Q000150:complications; D008585:Meningitis, Meningococcal / Q000150:complications; D008586:Meningitis, Pneumococcal / Q000150:complications; D009999:Ossification, Heterotopic / Q000209:etiology; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology*; D013065:Speech Intelligibility / Q000502:physiology; D013067:Speech Perception / Q000502:physiology; D013997:Time Factors; D014705:Verbal Behavior / Q000502:physiology; D015837:Vestibular Diseases / Q000209:etiology