Department of Otolaryngology, Bionic Ear Institute, University of Melbourne, Melbourne, Victoria, Australia.
Otolaryngol Head Neck Surg. 2010 Nov;143(5 Suppl 3):S15-23. doi: 10.1016/j.otohns.2010.08.010.
This review describes the current concept of pneumococcal meningitis in cochlear implant recipients based on recent laboratory studies. It examines possible routes of Streptococcus pneumoniae infection to the meninges in cochlear implant recipients. It also provides insights into fundamental questions concerning the pathophysiology of pneumococcal meningitis in implant recipients.
Medline/PubMed database; English articles after 1960. Search terms: cochlear implants, meningitis, pneumococcus, streptococcus pneumonia.
Narrative review. All articles relating to post-implant meningitis without any restriction in study designs were assessed and information extracted.
The incidence of pneumococcal meningitis in cochlear implant recipients is greater than that of an age-matched cohort in the general population. Based on the current clinical literature, it is difficult to determine whether cochlear implantation per se increases the risk of meningitis in subjects with no existing risk factors for acquiring the disease. As this question cannot be answered in humans, the study of implant-related infection must involve the use of laboratory animals in order for the research findings to be applicable to a clinical situation. The laboratory research demonstrated the routes of infection and the effects of the cochlear implant in lowering the threshold for pneumococcal meningitis.
The laboratory data complement the existing clinical data on the risk of pneumococcal meningitis post-cochlear implantation.
本综述基于近期实验室研究，描述了接受人工耳蜗植入的患者中肺炎球菌性脑膜炎的现有概念。文中探讨了人工耳蜗植入患者发生脑膜炎的肺炎链球菌可能感染途径，并就人工耳蜗植入患者中肺炎球菌性脑膜炎的病理生理学的一些基本问题提供了新的见解。
Medline/PubMed 数据库；1960 年后的英文文章。检索词：人工耳蜗植入、脑膜炎、肺炎球菌、肺炎链球菌。
叙述性综述。评估了所有与植入后脑膜炎相关且无研究设计限制的文章，并提取了信息。
接受人工耳蜗植入的患者发生肺炎球菌性脑膜炎的发生率高于一般人群中同龄患者。基于目前的临床文献，很难确定人工耳蜗植入本身是否会增加无疾病相关危险因素患者发生脑膜炎的风险。由于这个问题无法在人体中得到解答，因此研究植入物相关感染必须使用实验动物，以便研究结果适用于临床情况。实验室研究表明了感染途径和人工耳蜗植入降低肺炎球菌性脑膜炎发病阈值的作用。
实验室数据补充了人工耳蜗植入后发生肺炎球菌性脑膜炎风险的现有临床数据。
