Roukema B Y, Van Loon M C, Smits C, Smit C F, Goverts S T, Merkus P, Hensen E F
Department of Otolaryngology and Head and Neck Surgery, VU University Medical Center Amsterdam, KNO ZH1D-116, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Int J Otolaryngol. 2011;2011:845879. doi: 10.1155/2011/845879. Epub 2011 Dec 20.
Objective. To describe the audiological, anesthesiological, and surgical key points of cochlear implantation after bacterial meningitis in very young infants. Material and Methods. Between 2005 and 2010, 4 patients received 7 cochlear implants before the age of 9 months (range 4-8 months) because of profound hearing loss after pneumococcal meningitis. Results. Full electrode insertions were achieved in all operated ears. The audiological and linguistic outcome varied considerably, with categories of auditory performance (CAP) scores between 3 and 6, and speech intelligibility rating (SIR) scores between 0 and 5. The audiological, anesthesiological, and surgical issues that apply in this patient group are discussed. Conclusion. Cochlear implantation in very young postmeningitic infants is challenging due to their young age, sequelae of meningitis, and the risk of cochlear obliteration. A swift diagnostic workup is essential, specific audiological, anesthesiological, and surgical considerations apply, and the outcome is variable even in successful implantations.
目的。描述极年幼婴儿细菌性脑膜炎后人工耳蜗植入的听力学、麻醉学和手术要点。材料与方法。2005年至2010年间,4例患者因肺炎球菌性脑膜炎后重度听力损失,在9个月龄前(4至8个月)接受了7次人工耳蜗植入。结果。所有手术耳均实现了电极完全插入。听力学和语言结果差异很大,听觉表现(CAP)评分在3至6之间,言语可懂度评分(SIR)在0至5之间。讨论了适用于该患者群体的听力学、麻醉学和手术问题。结论。极年幼的脑膜炎后婴儿进行人工耳蜗植入具有挑战性,原因在于其年龄小、脑膜炎后遗症以及耳蜗闭塞的风险。快速的诊断检查至关重要,需要考虑特定的听力学、麻醉学和手术因素,即使植入成功,结果也存在差异。