Post-meningitis cochlear implantation

Abstract

Background and aim: Bacterial meningitis, mainly Streptococcus pneumonia, is a primary cause of profound bilateral sensorineural hearing loss. Post-meningitic cochlear ossification, bony cochlear lumen obliteration, and often complicates cochlear implantation (CI) are happen post meningitis. The aim of this study is to evaluate the hearing outcomes and complications of CI in patients with hearing loss due to bacterial meningitis.
Methods: A 10-year retrospective review of 45 patients (pediatric and adult) underwent CI after bacterial meningitis at Martyr Gazi Alhariri Hospital, between 2012 and 2022. The outcomes were analyzed using speech perception scores, radiological imaging findings, and surgical reports for each patient.
Results: Early implantation (≤3 months post-meningitis) correlated with higher open-set speech recognition. Ossification severity inversely predicted electrode insertion depth (r= -0.67, p<0.01). In terms of audiological outcomes, open-set speech recognition was achieved in 62.2% of the patients (28/45), and pediatric showed significantly better performance than adults (75.0% vs. 35.3%). Similarly, early CI (≤3 months post-meningitis) was associated with higher rates of open-set speech recognition than was delayed implantation (>3 months) (72.7% vs. 43.5%; p = 0.003). The mean speech intelligibility rating (SIR) score for the entire cohort was 3.4±1.2, with pediatric patients scoring significantly higher than adults (4.1±0.8 vs. 2.7±1.1, respectively; p = 0.01).
Conclusion: Early CI and computed tomography (CT)  imaging are critical for achieving better outcomes in post-meningitic deafness. Anticipatory CI within 3 months of post-meningitis enhances outcomes. Advanced imaging and adaptable surgical strategies can alleviate ossification-related challenges.