Alshaikh Mohammed, Alahmadi Asmaa, Albedry Mohammed, Alharbi Abdulmajeed, Alenzi Saad, Almahyawi Rawan, Mansouri NoorJehan, Albaqeyah Mohammad, Alamri Abdullah, Alharbi Amani A, Aldajani Ahmad
ENT and Cochlear Implant Center, Royal Commission Hospital, Jubail, SAU.
Otolaryngology Head and Neck Surgery Department, King Fahad Hospital, Jeddah, SAU.
Cureus. 2019 Sep 13;11(9):e5650. doi: 10.7759/cureus.5650.
Objective Patients with post-meningitis deafness remain challenging candidates for cochlear implantation (CI) which can be difficult due to fibrosis or ossification of the inner ear, and their outcomes remain doubtful. We assessed the surgical and audiological outcomes of CI in patients with profound sensorineural hearing loss caused by meningitis and compared those outcomes to patients without cochlear ossification. Methods This retrospective cross-sectional study was carried out at King Fahad General Hospital, Jeddah, Saudi Arabia. Among 246 patients who underwent cochlear implantation, 13 patients with post-meningitic deafness were identified (Group 1). A matched control group, including patients with deafness due to other causes who did not have cochlea osteogenesis, was selected (Group 2). For all patients, data were collected from medical records, including surgical and audiological outcomes. Results Sclerosis of the cochlea was high in Group 1 (46.2%). There were no postoperative surgical complications in either group. Responses of the auditory nerve action potential obtained through auditory response telemetry (ART) or the neural response telemetry (NRT) were recorded. There was no significant difference between the two groups regarding the intraoperative and the postoperative ART or NRT at selected electrodes representing the entire cochlea. Likewise, no significant difference regarding the speech recognition test (SRT) was detected. Conclusions Cochlear implantation is a safe procedure without surgical complications in post-meningitis patients. Furthermore, early CI in children was associated with favorable outcomes in terms of preservation of the auditory nerve response, restoration of speech discrimination, and recognition to levels comparable to patients with deafness due to other causes. Early audiological assessment in meningitis patients is recommended to identify hearing loss and eventually to offer CI.
目的 脑膜炎后耳聋患者仍是具有挑战性的人工耳蜗植入（CI）候选者，这可能因内耳纤维化或骨化而困难，且其预后仍不确定。我们评估了脑膜炎导致的极重度感音神经性听力损失患者人工耳蜗植入的手术和听力学结果，并将这些结果与无耳蜗骨化的患者进行比较。方法 这项回顾性横断面研究在沙特阿拉伯吉达的法赫德国王总医院进行。在246例接受人工耳蜗植入的患者中，确定了13例脑膜炎后耳聋患者（第1组）。选择一个匹配的对照组，包括因其他原因导致耳聋且无耳蜗骨生成的患者（第2组）。对于所有患者，从病历中收集数据，包括手术和听力学结果。结果 第1组耳蜗硬化率较高（46.2%）。两组均无术后手术并发症。记录通过听觉反应遥测（ART）或神经反应遥测（NRT）获得的听神经动作电位反应。在代表整个耳蜗的选定电极上，两组在术中及术后ART或NRT方面无显著差异。同样，在言语识别测试（SRT）方面也未检测到显著差异。结论 人工耳蜗植入对于脑膜炎后患者是一种安全的手术，无手术并发症。此外，儿童早期人工耳蜗植入在保留听神经反应、恢复言语辨别和识别能力方面与因其他原因导致耳聋的患者相当，具有良好的预后。建议对脑膜炎患者进行早期听力学评估，以识别听力损失并最终提供人工耳蜗植入。
