Cochlear Implantation for Post-Meningitic Deafness in New Zealand Children – A 20-Year Retrospective Review
Dr Ben Thomson, Registrar, Northland Hospital, New Zealand
Authors List
Introduction
Sensorineural hearing loss is a potentially devastating sequela following bacterial meningitis1,2. This requires prompt diagnosis, imaging, and referral to a cochlear implantation service due to the rapid rate of labyrinthitis ossificans2. This can render cochlear implantation difficult or even impossible and have long term implications for hearing rehabilitation2.
Aims
This study reviews paediatric patients who have undergone cochlear implantation for post-meningitic deafness in New Zealand, including the time to assessment and implantation, demographics, and outcomes.
Methodology
This is a retrospective case series. Following ethics review, children who underwent implantation between January 2000 and July 2020 were identified. Both electronic and paper records were accessed to obtain demographic, microbiological, operative, radiological and outcome data (both usage and language).
Results
48 children were identified as having undergone either unilateral or bilateral cochlear implantation for post meningitic deafness. There was a disproportional number of children from deprived areas and a significant burden of disease with Māori (n=22). The median time to diagnosis of hearing loss was 31 days and implantation was 76 days. Language outcome data indicates that these children do poorly, especially when compared to those who undergo implantation for congenital deafness. 17 children who have been lost to follow up through the programmes, assumed non-users.
Conclusions
This study demonstrates delays in the assessment of hearing and referral for cochlear implantation in New Zealand. Cochlear implantation for post-meningitic deafness affects a disproportional amount of Māori children, and those from areas of socioeconomic deprivation. These children do worse with implantation likely due to a number of factors.
- Thomson BJ, Christchurch Hospital, Christchurch New Zealand
- Teagle H, The Northern Cochlear Implantation Programme Walls T, Christchurch Hospital, Christchurch New Zealand
- Bird P, Christchurch Hospital, Christchurch New Zealand; The Northern Cochlear Implantation Programme
- Souter M, Christchurch Hospital, Christchurch New Zealand; The Northern Cochlear Implantation Programme2
Introduction
Sensorineural hearing loss is a potentially devastating sequela following bacterial meningitis1,2. This requires prompt diagnosis, imaging, and referral to a cochlear implantation service due to the rapid rate of labyrinthitis ossificans2. This can render cochlear implantation difficult or even impossible and have long term implications for hearing rehabilitation2.
Aims
This study reviews paediatric patients who have undergone cochlear implantation for post-meningitic deafness in New Zealand, including the time to assessment and implantation, demographics, and outcomes.
Methodology
This is a retrospective case series. Following ethics review, children who underwent implantation between January 2000 and July 2020 were identified. Both electronic and paper records were accessed to obtain demographic, microbiological, operative, radiological and outcome data (both usage and language).
Results
48 children were identified as having undergone either unilateral or bilateral cochlear implantation for post meningitic deafness. There was a disproportional number of children from deprived areas and a significant burden of disease with Māori (n=22). The median time to diagnosis of hearing loss was 31 days and implantation was 76 days. Language outcome data indicates that these children do poorly, especially when compared to those who undergo implantation for congenital deafness. 17 children who have been lost to follow up through the programmes, assumed non-users.
Conclusions
This study demonstrates delays in the assessment of hearing and referral for cochlear implantation in New Zealand. Cochlear implantation for post-meningitic deafness affects a disproportional amount of Māori children, and those from areas of socioeconomic deprivation. These children do worse with implantation likely due to a number of factors.
- Du Y, Xihong W, Laing L. Mechanism of bacterial meningitis-related deafness. Drug Discovery Today: Disease Mechanisms. 2006. 3(1):115-118.
- Liu CC, Sweeney M, Booth TN, Lee KH, Kutz JW, Roland P, et al. The Impact of Postmeningitic Labyrinthitis Ossificans on Speech Performance After Pediatric Cochlear Implantation. Otol Neurotol 2015; 36: 1633-7.
