engleski

Cochlear implantation after deafness caused by meningitis

INTRODUCTION: We are presenting a case of a 53- year-old female with deafness after Streptococcus pneumoniae meningitis. CASE DESCRIPTION: A 53- year-old female patient was admitted to our department for urgent cochlear implantation. 5 months ago, the patient had meningitis caused by S. pneumoniae. She was in a coma and was mechanically ventilated. After one month she became conscious but paraplegic and communication was very difficult. After three weeks of physical therapy, she could move but hemiplegia was still present. Pure tone audiometry showed sensorineural deafness. MRI of the head and temporal bone showed a high signal intensity in both cochleas but higher in the right cochlea, which is a sign of postinfectious fibrosis. Otoscopy was normal. We decided to perform an urgent cochlear implantation in the left ear, where were still signs of fluid inside the cochlea which indicated only partial fibrosis. Intraoperatively full insertion could not be performed due to fibrosis but partial insertion was performed. After activation of the cochlear implant, she showed significant improvement and after a month she could communicate. DISCUSSION: Meningitis, especially bacterial, can result in severe sensorineural hearing loss. Hearing loss can occur immediately or it can progress during the following weeks and months. After the acute stage, the inflammation may progress to fibrosis and ossification of the cochlea lumen. This can make cochlear implant placement difficult or even impossible. CONCLUSION: Sensorineural deafness can occur after bacterial meningitis. It is important to perform an MRI scan of the temporal bone as soon as possible, before the complete fibrosis of the cochlea occurs. If the fibrosis is complete cochlear implantation is not possible.

deafness ; cochlear implant ; meningitis

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