Kamkari Nick, Chari Divya
Otolaryngology-Head and Neck Surgery, University of Massachusetts Chan Medical School, Worcester, USA.
Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, USA.
Cureus. 2023 Feb 2;15(2):e34555. doi: 10.7759/cureus.34555. eCollection 2023 Feb.
This report describes a case of cochlear implantation to treat profound deafness three months after a diagnosis of bacterial meningitis in a patient with a remote history of splenectomy. A 71-year-old woman with a remote history of a splenectomy over 20 years before presented with bilateral profound deafness that occurred as sequela from pneumococcal meningitis three months prior. The patient had been vaccinated against the 23-valent polysaccharide pneumococcal vaccine (PPV-23). The audiometric evaluation revealed no response in either ear. Imaging was suggestive of complete ossification of the right cochlea with partial ossification of the basal turn of the left cochlea. She underwent successful left-sided cochlear implantation. Standard post-implantation speech outcomes include consonant-nucleus-consonant (CNC) word and phoneme scores and Az-Bio in quiet and noise. The patient noted subjective improvement in her hearing. Performance measures markedly improved when compared to her pre-operative evaluation, which showed no aided sound detection. This case report highlights the possibility of meningitis many years after splenectomy that can result in profound deafness with labyrinthitis ossificans and the potential for hearing rehabilitation for cochlear implantation.
本报告描述了一例在有脾切除既往史的患者中，诊断为细菌性脑膜炎三个月后进行人工耳蜗植入治疗重度耳聋的病例。一名71岁女性，20多年前有脾切除既往史，三个月前因肺炎球菌性脑膜炎后遗症出现双侧重度耳聋。该患者已接种23价肺炎球菌多糖疫苗（PPV-23）。听力评估显示双耳均无反应。影像学检查提示右侧耳蜗完全骨化，左侧耳蜗底转部分骨化。她成功接受了左侧人工耳蜗植入。标准的植入后言语结果包括安静和噪声环境下的辅音-元音-辅音（CNC）单词和音素得分以及Az-Bio测试。患者感觉听力有主观改善。与术前评估相比，性能指标有显著改善，术前评估显示无助听器声音检测。本病例报告强调了脾切除多年后发生脑膜炎导致伴有骨化性迷路炎的重度耳聋以及人工耳蜗植入听力康复潜力的可能性。
