Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T10:51:32.478Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of cochlear implantation in post-meningitic adults

Published online by Cambridge University Press:  29 June 2007

J. Thomas  and
I. M. Cheshire
J. Thomas*
Affiliation:
Midland Cochlear Implant Programme, Department of Otolaryngology, University Hospital Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
I. M. Cheshire
Affiliation:
Midland Cochlear Implant Programme, Department of Otolaryngology, University Hospital Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
*
Address for correspondence: Mrs Julie Thomas, Senior Specialist Speech and Language Therapist, Hearing Assessment and Rehabilitation Centre, Selly Oak Hospital, Raddlebarn Road, Selly Oak, Birmingham, West Midlands B29 6JD.
Get access Rights & Permissions [Opens in a new window]

Abstract

Meningitis is an important cause of deafness and in some studies has been associated with poorer outcomes in adult patients following cochlear implantation. Of the first 100 adults implanted under the Midland Cochlear Implant Programme, 28 were deafened as a result of meningitis. We compare our experience with these patients with patients with a non-meningitic aetiology.

A degree of cochlear ossification was a more common finding in the meningitic group. In six cases (four meningitics, two non-meningitics) ossification was encountered only during surgery, not being apparent on pre-operative radiology.

The average scores achieved on auditory tests by the meningitic group were similar to those achieved by non-meningitic patients. At nine months, using only the implant, users were able to identify 54 per cent of common environmental sounds, achieved an average score of 30 words per minute on connected discourse tracking and identified an average of 42 per cent of words correctly in BKB sentences.

Poorer outcomes were more commonly associated with cochlear ossification. In patients with cognitive and neurological sequelae, benefits with the implant were not always apparent in the early months, however, with intensive therapy these patients can obtain measurable sustained benefit from their implant.

Keywords

Cochlear implantsMeningitis
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 113 , Supplement 24 , August 1999 , pp. 27 - 33
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Battmer, R. D., Gupta, S. P., Allum-Mecklenburg, D. J., Lenarz, T. (1995) Factors influencing cochlear implant perceptual performance in 132 adults. International Cochlear Implant, Speech and Hearing Symposium – Melbourne 1994 (Clark, G. M., Cowan, R. S. C., eds.), Annals of Otology, Rhinology and Laryngology (Suppl 166): 185–187.Google ScholarPubMed
Bird, A. S., MacDonald, A. J. D., Mann, A. H., Philpot, M. P. (1987) Preliminary experience with the SELFCARE(D): a self-rating depression questionnaire for use in elderly non-institutionalized subjects. International Journal of Geriatric Psychiatry 2: 21–38.CrossRefGoogle Scholar
Bohr, V., Paulson, O. B., Rassmussen, N. (1984) Pnemococcal meningitis. Late neurologic sequelae and features of prognostic impact. Archives of Neurology 41: 1045–1049.CrossRefGoogle Scholar
Dodge, P. R., Davis, H., Feigin, R. D., Holmes, S. J., Kaplan, S. L., Jubelirer, D. P., Stechenberg, B. W., Hirsch, S. K. (1984) Prospective evaluation of hearing impairment as a sequela of acute bacterial meningitis. New England Journal of Medicine 311: 869–874.CrossRefGoogle ScholarPubMed
Geier, L., Gilden, J., Luetje, C. M., Maddox, H. E. (1993) Delayed perception of cochlear implant stimulation in children with post-meningitic ossified cochleae. American Journal of Otology 4: 556–561.Google Scholar
Kaplan, S. L., Feigin, R. D. (1985) Clinical presentations, prognostic factors and diagnosis of bacterial meningitis. In Contemporary Issues in Infectious Disease. Vol. 3. Bacterial Meningitis. (Sande, M. A., Smith, A. L., Rook, R. K. eds.), Churchill Livingstone, New York, pp 83–94.Google Scholar
Noah, N. D. (1987) Epidemiology of bacterial meningitis: UK and USA. In Bacterial Meningitis. (Williams, J. D., Burnie, J., eds), Academic Press Inc. (London) Ltd., London pp 93–115.Google Scholar
Office for National Statistics. Communicable Disease Surveillance Centre of the Public Health Laboratory Service. Communicable Disease Statistics, England and Wales 1989–1994. Series MB2 No's 16–21. A publication of the Government Statistical Service. HMSO, London.Google Scholar
Parnes, L. S., Gague, J-P., Hassan, R. (1993) Cochlear implants and otitis media: considerations of 2 cleft palate patients. Journal of Otolaryngology 22(5): 345–348.Google Scholar
Parsons, M. (1979) Tuberculous Meningitis. A Handbook for Clinicians. Oxford University Press, New York.Google Scholar
Scheld, W. M., Quagliarello, V. J., Lesse, A. J. (1987) Selected aspects of the pathogenesis and pathophysiology of bacterial meningitis. In Bacterial Meningitis. (Williams, J. D., Burnie, J., eds), Academic Press Inc. (London) Ltd., London pp 1–28.Google Scholar
Shelton, M. M., Marks, W. A. (1990) Bacterial meningitis: An update. Pediatric Neurology 8: 605–617.Google ScholarPubMed
Smith, A. L., Roberts, M. C., Haas, J. E., Stull, T. L., Mendelman, P. M. (1985) Mechanisms of Haemophilus influenzae type b meningitis. In Contemporary Issues in Infectious Disease. Vol. 3. Bacterial Meningitis. (Sande, M. A., Smith, A. L., Rook, R. K., eds.), Churchill Livingstone, New York, pp 11–21.Google Scholar
Sood, R. K., Singh, R. S., Allen, A., Highet, M., McEwan, E., Whitelaw, R. (1994) Meningitis in Scotland: Its Implications for Cochlear Implants. International Cochlear Implant, Speech and Hearing Symposium – Melbourne 1994 (Clark, G. M., Cowan, R. S. C., eds.), Annals of Otology, Rhinology and Laryngology (Suppl 166): 436–438.Google Scholar
Summerfield, A. Q., Marshall, D. (1995) Cochlear Implantation in the UK 1990–1994. Report by the MRC Institute of Hearing Research on the Evaluation of the National Cochlear Implant Programme. Main report. HMSO.Google Scholar
Waltzman, S. B., Fisher, S. G., Niparko, J. K., Cohen, N. L. (1995) Predictors of post-operative performance with cochlear implants. Multicenter Comparative Study of Cochlear Implants: Final reports of the Department of Veterans Affairs Cooperative Studies Program (Cohen, N. L., Waltzman, S. B., eds.). Annals of Otology, Rhinology and Laryngology (Suppl 165): 15–18.Google Scholar