Neo W L, Durisala N, Ho E C
Department of Otolaryngology,Tan Tock Seng Hospital,Singapore.
Department of Audiology,Tan Tock Seng Hospital,Singapore.
J Laryngol Otol. 2016 Jul;130(7):691-5. doi: 10.1017/S002221511600801X. Epub 2016 May 23.
Sensorineural hearing loss is a recognised complication of cryptococcal meningitis. The mechanism of hearing loss in patients with cryptococcal meningitis is different from that in bacterial meningitis.
An immune-competent man with cryptococcal meningitis presented with sudden onset, bilateral, severe to profound sensorineural hearing loss and vestibular dysfunction. He was initially evaluated for cochlear implantation. However, he had a significant recovery; he no longer required surgery and was able to cope without a hearing aid.
Typically, cochlear implantation is performed with some urgency in patients with hearing loss post-bacterial meningitis, because of the risk of labyrinthitis ossificans. However, this process has not been described in patients with cryptococcal meningitis. Furthermore, patients with hearing loss associated with cryptococcal meningitis have shown varying degrees of reversibility. In this case report, hearing loss from cryptococcal meningitis is compared with that from bacterial meningitis, and the need for cochlear implantation in patients with cryptococcal meningitis is discussed.
感音神经性听力损失是隐球菌性脑膜炎公认的并发症。隐球菌性脑膜炎患者听力损失的机制与细菌性脑膜炎患者不同。
一名免疫功能正常的隐球菌性脑膜炎男性患者，突发双侧严重至极重度感音神经性听力损失及前庭功能障碍。他最初接受了人工耳蜗植入评估。然而，他有显著恢复；不再需要手术，且无需助听器就能生活。
通常，细菌性脑膜炎后听力损失患者因存在骨化性迷路炎风险，会紧急进行人工耳蜗植入。然而，这一过程在隐球菌性脑膜炎患者中尚未见描述。此外，与隐球菌性脑膜炎相关的听力损失患者已表现出不同程度的可逆性。在本病例报告中，比较了隐球菌性脑膜炎与细菌性脑膜炎所致的听力损失，并讨论了隐球菌性脑膜炎患者人工耳蜗植入的必要性。
