Mandalà M, Colletti L
ENT Department, University of Verona, Italy.
J Laryngol Otol. 2012 Jan;126(1):72-5. doi: 10.1017/S0022215111002726. Epub 2011 Oct 6.
We report a rare presentation of otogenic bacterial meningitis secondary to a stapes footplate malformation in a paediatric patient with an auditory brainstem implant.
A patient with Mondini's dysplasia developed meningitis six years after auditory brainstem implantation. The aetiology was believed to be otogenic, secondary to stapes footplate malformation.
To our best knowledge, this is the first report of otogenic bacterial meningitis secondary to stapes footplate malformation in a paediatric patient with an auditory brainstem implant. Subjects with inner ear malformations, especially Mondini's dysplasia, need to be carefully evaluated pre-operatively to reduce or eliminate any anatomical conditions which may predispose to meningitis. In children with an auditory brainstem implant and suspected ear malformation, we recommend pre-operative radiological investigation to look for the 'bulging oval window' sign. When radiological signs are positive, bilateral exploratory tympanotomy should be performed to detect any undiagnosed anatomical stapes footplate defects, which may predispose to bacterial meningitis.
我们报告了一例罕见的小儿患者，其因镫骨足板畸形继发耳源性细菌性脑膜炎，该患者植入了听觉脑干植入物。
一名患有Mondini发育不全的患者在听觉脑干植入术后六年发生了脑膜炎。病因被认为是耳源性的，继发于镫骨足板畸形。
据我们所知，这是首例关于小儿听觉脑干植入患者因镫骨足板畸形继发耳源性细菌性脑膜炎的报告。内耳畸形患者，尤其是Mondini发育不全患者，术前需要仔细评估，以减少或消除任何可能易患脑膜炎的解剖学状况。对于植入听觉脑干植入物且怀疑有耳部畸形的儿童，我们建议进行术前影像学检查以寻找“椭圆形窗膨出”征。当影像学征象为阳性时，应进行双侧探查性鼓室切开术，以检测任何可能易患细菌性脑膜炎的未诊断出的镫骨足板解剖缺陷。
