Cochlear implantation for post-meningitis deafness with cochlear ossification: diagnosis and surgical strategy

Abstract

Background

Cochlear ossification (CO) after meningitis can cause profound sensorineural hearing loss (SNHL). Cochlear implantation (CI) is the ideal treatment strategy for CO.

Aims

To explore the strategy for CI in patients with CO after meningitis.

Materials and Methods

In this retrospective study, the medical records of patients diagnosed with profound SNHL due to CO after meningitis and who underwent CI in our department between September 2010 and September 2021 were collected and reviewed. Their imaging and surgical findings were analyzed.

Results

The data of 26 patients with unilateral CI were reviewed. All patients underwent preoperative temporal high-resolution computed tomography (HRCT) and 22 patients magnetic resonance imaging (MRI). The sensitivity of HRCT was 61.5% (10/26), whereas that of MRI was 81.8% (18/22). Combined HRCT and MRI achieved a detection rate of 92.3% (24/26). Twenty-two and four patients underwent complete and partial electrode implantations, respectively.

Conclusions and Significance

Preoperative temporal bone HRCT and MRI are essential for determining whether a patient is suitable for CI and surgical planning. A false-negative diagnosis is possible when diagnosing CO, but combined HRCT and MRI can improve the positive rate of preoperative diagnosis of CO post meningitis. Early CI is recommended.

Chinese Abstract

背景：脑膜炎后的耳蜗骨化 (CO) 可导致严重的感音神经性听力损失（SNHL）。人工耳蜗植入 (CI) 是 CO 的理想治疗方案。

目的：探讨脑膜炎后CO患者的CI治疗方案。

材料和方法：在这项回顾性研究中, 收集和审查了2010年9月至2021年9月期间诊断为脑膜炎后因 CO 所致严重 SNHL 并在我们科室接受 CI 的患者的病历。分析了他们的影像结果和手术结果。

结果：回顾了26例单侧CI患者的资料。所有患者均在术前进行了时间高分辨率计算机断层扫描 (HRCT) 和 22 名患者接受了磁共振成像（核磁共振）。 HRCT的敏感性为61.5%（10/26）, 而MRI的敏感性为81.8%（18/22）。HRCT和MRI的综合检出率为92.3%（24/26）。 22 名和 4 名患者分别接受了完全和部分电极植入。

结论和意义：术前颞骨 HRCT 和 MRI 对于确定患者是否适合 CI 及确定手术计划至关重要。在诊断 CO 时可能出现假阴性诊断。联合 HRCT 和 MRI 两者可以提高脑膜炎后 CO 的术前诊断阳性率。建议早些进行耳蜗植入。

Keywords:

• Meningitis
• cochlear implantation
• cochlear ossification
• sensorineural hearing loss
• radiology

Acknowledgements

The authors thank Editage (www.editage.cn) for English language editing.

Disclosure statement

The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of this manuscript.

Additional information

Funding

This work was supported by the Beijing Municipal Science and Technology Commission under Project of Capital Clinical Characteristic Application Research [No. Z171100001017079]; Beijing Municipal Bureau of Finance under the Capital Health Research and Development of Special [No. 2020-2-2057].