Cochlear implantation for post-meningitis deafness with cochlear ossification: diagnosis and surgical strategy

Abstract Background Cochlear ossification (CO) after meningitis can cause profound sensorineural hearing loss (SNHL). Cochlear implantation (CI) is the ideal treatment strategy for CO. Aims To explore the strategy for CI in patients with CO after meningitis. Materials and Methods In this retrospective study, the medical records of patients diagnosed with profound SNHL due to CO after meningitis and who underwent CI in our department between September 2010 and September 2021 were collected and reviewed. Their imaging and surgical findings were analyzed. Results The data of 26 patients with unilateral CI were reviewed. All patients underwent preoperative temporal high-resolution computed tomography (HRCT) and 22 patients magnetic resonance imaging (MRI). The sensitivity of HRCT was 61.5% (10/26), whereas that of MRI was 81.8% (18/22). Combined HRCT and MRI achieved a detection rate of 92.3% (24/26). Twenty-two and four patients underwent complete and partial electrode implantations, respectively. Conclusions and Significance Preoperative temporal bone HRCT and MRI are essential for determining whether a patient is suitable for CI and surgical planning. A false-negative diagnosis is possible when diagnosing CO, but combined HRCT and MRI can improve the positive rate of preoperative diagnosis of CO post meningitis. Early CI is recommended.

[1]  W. Liang,et al.  Validation of the Mandarin versions of CAP and SIR. , 2020, International journal of pediatric otorhinolaryngology.

[2]  S. Yetişer,et al.  Double challenge: cochlear implantation in the only hearing ear with progressive hearing loss following meningitis and vestibular dysfunction after implantation , 2019, Journal of otology.

[3]  A. Kara,et al.  The Effect of National Pneumococcal Vaccination Program on Incidence of Postmeningitis Sensorineural Hearing Loss and Current Treatment Modalities. , 2019, The journal of international advanced otology.

[4]  A. Eshraghi,et al.  Cochlear Implant Electrode Choice in Challenging Surgical Cases: Malformation, Residual Hearing, Ossification, or Reimplantation , 2017, Current Otorhinolaryngology Reports.

[5]  R. Briggs,et al.  Contemporary surgical issues in paediatric cochlear implantation , 2016, International journal of audiology.

[6]  P. Cayé-Thomasen,et al.  Cochlear ossification in patients with profound hearing loss following bacterial meningitis , 2012, Acta oto-laryngologica.

[7]  J. Roland,et al.  Implanting obstructed and malformed cochleae. , 2012, Otolaryngologic clinics of North America.

[8]  Xueqing Chen,et al.  [Analysis of reliability and validity of the Chinese version of Nijmegen Cochlear Implant Questionnaire]. , 2010, Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery.

[9]  P. Ferron,et al.  Cochlear Implantation in Postmeningitic Deafness , 2010, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[10]  T. Balkany,et al.  Implantation of the Ossified Cochlea , 2005 .

[11]  H. Brodie,et al.  Chronology of labyrinthitis ossificans induced by streptococcus pneumoniae meningitis , 1999, The Laryngoscope.