Rapid Recovery of Speech Perception After Cochlear Implantation: A Case Report of Cochlear Implantation in Post-Meningitis Deafness
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Abstract
Background: It takes some time for a patient to adapt to the new hearing experience with a cochlear implant (CI) device. Usually, improvements of speech perception have been reported within 3 to 6 months after the CI surgery. Here, we described a child with post-lingual deafness due to meningitis who recovered considerable speech perception just a few days after CI activation.
The Case: A 14-year-old female with complaints of severe headache, delirium, unresponsiveness to sound, and agitation was diagnosed with meningitis. Pure tone audiometry showed total deafness in right ear and severe to profound sensorineural hearing loss in left ear. Seven months after onset of deafness, she received a Cochlear Nucleus CI512 implant in the right ear. The speech processor was activated 2 weeks after surgery. The first map was programmed using the advanced combinational encoder (ACE) speech coding strategy and behavioral measurement of T-levels and C-levels. Four days later, the audiometric evaluation revealed a pure-tone average (PTAve) of 35 dB HL, accompanied by a speech discrimination score (SDS) of 72%. The Bamford-Kowal-Bench (BKB) sentence test yielded a score of 80% in silence. Two weeks after device activation, PTAve was 20 dB HL, the SDS was 86% and the BKB sentence score in silence was 100%. There are numerous factors related to postoperative function with CI.
Conclusions: It seems that factors like short duration of deafness, precise mapping of CI speech processor, consistent device usage, and rich aural environment have led to extraordinary improvement within 2 weeks after device activation.
2. Douglas SA, Sanli H, Gibson WP. Meningitis resulting in hearing loss and labyrinthitis ossificans - does the causative organism matter? Cochlear Implants Int. 2008;9(2):90-6. [DOI:10.1179/cim.2008.9.2.90]
3. Lenarz M, Sönmez H, Joseph G, Büchner A, Lenarz T. Long-term performance of cochlear implants in postlingually deafened adults. Otolaryngol Head Neck Surg. 2012;147(1):112-8. [DOI:10.1177/0194599812438041]
4. Ebrahimi-Madiseh A, Eikelboom RH, Jayakody DM, Atlas MD. Speech perception scores in cochlear implant recipients: An analysis of ceiling effects in the CUNY sentence test (Quiet) in post-lingually deafened cochlear implant recipients. Cochlear Implants Int. 2016;17(2):75-80. [DOI:10.1080/14670100.2015.1114220]
5. Bernhard N, Gauger U, Romo Ventura E, Uecker FC, Olze H, Knopke S, et al. Duration of deafness impacts auditory performance after cochlear implantation: A meta-analysis. Laryngoscope Investig Otolaryngol. 2021;6(2):291-301. [DOI:10.1002/lio2.528]
6. Bille J, Ovesen T. Cochlear implant after bacterial meningitis. Pediatr Int. 2014;56(3):400-5. [DOI:10.1111/ped.12252]
7. Frau GN, Luxford WM, Lo WW, Berliner KI, Telischi FF. High-resolution computed tomography in evaluation of cochlear patency in implant candidates: a comparison with surgical findings. J Laryngol Otol. 1994;108(9):743-8. [DOI:10.1017/s0022215100128002]
8. Isaacson B, Booth T, Kutz JW Jr, Lee KH, Roland PS. Labyrinthitis ossificans: how accurate is MRI in predicting cochlear obstruction? Otolaryngol Head Neck Surg. 2009;140(5):692-6. [DOI:10.1016/j.otohns.2008.12.029]
9. Mosnier I, Felice A, Esquia G, Borel S, Bouccara D, Ambert-Dahan E, et al. New cochlear implant technologies improve performance in post-meningitic deaf patients. Eur Arch Otorhinolaryngol. 2013;270(1):53-9. [DOI:10.1007/s00405-011-1918-y]
10. Helmstaedter V, Buechner A, Stolle S, Goetz F, Lenarz T, Durisin M. Cochlear implantation in children with meningitis related deafness: The influence of electrode impedance and implant charge on auditory performance - A case control study. Int J Pediatr Otorhinolaryngol. 2018;113:102-9. [DOI:10.1016/j.ijporl.2018.07.034]
11. Wang X, Tran P, Kapolowicz MR, Lu T, Stickney G, Starr A, et al. Customized strategies for managing cochlear implant stimulation side effects. Cochlear Implants Int. 2025:1-14. [DOI:10.1080/14670100.2025.2484860]
12. Bogdanov C, Mulders WHAM, Goulios H, Távora-Vieira D. The Impact of Patient Factors on Objective Cochlear Implant Verification Using Acoustic Cortical Auditory-Evoked Potentials. Audiol Neurootol. 2024;29(2):96-106. [DOI:10.1159/000533273]
13. Durisin M, Arnoldner C, Stöver T, Lenarz T, Lesinski-Schiedat A. Audiological performance in cochlear implanted patients deafened by meningitis depending on duration of deafness. Eur Arch Otorhinolaryngol. 2008;265(4):381-8. [DOI:10.1007/s00405-008-0584-1]
14. Oh SH, Kim CS, Kang EJ, Lee DS, Lee HJ, Chang SO, et al. Speech perception after cochlear implantation over a 4-year time period. Acta Otolaryngol. 2003;123(2):148-53. [DOI:10.1080/0036554021000028111]
15. Ching TY, van Wanrooy E, Dillon H. Binaural-bimodal fitting or bilateral implantation for managing severe to profound deafness: a review. Trends Amplif. 2007;11(3):161-92. [DOI:10.1177/1084713807304357]
16. Heutink F, Verbist BM, van der Woude WJ, Meulman TJ, Briaire JJ, Frijns JHM, et al. Factors Influencing Speech Perception in Adults With a Cochlear Implant. Ear Hear. 2021;42(4):949-60.
17. Breitsprecher TM, Baumgartner WD, Brown K, Dazert S, Doyle U, Dhanasingh A, et al. Effect of Cochlear Implant Electrode Insertion Depth on Speech Perception Outcomes: A Systematic Review. Otol Neurotol Open. 2023;3(4):e045. [DOI:10.1097/ONO.0000000000000045]
18. Cesur S, Yüksel M, Çiprut A. Data logging variables and speech perception in prelingually deafened pediatric cochlear implant users. Int J Pediatr Otorhinolaryngol. 2020;133:110003. [DOI:10.1016/j.ijporl.2020.110003]
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