Strategies for Hearing Protection in Children After Bacterial Meningitis
Main Article Content
Abstract
Bacterial meningitis is an acute infectious disease with a high incidence in children and carries a significant risk of long-term neurological sequelae, among which sensorineural hearing loss (SNHL) is the most common. The underlying pathophysiological mechanisms include the spread of bacteria from the subarachnoid space into the cochlea, resulting in labyrinthitis and subsequent cochlear ossification, occlusion of the labyrinthine artery and the administration of ototoxic medications. Hearing loss represents the most frequently reported neurological complication of bacterial meningitis, although its incidence varies across studies. Diagnosis relies on a combination of audiological assessments, including Otoacoustic Emissions (OAE), Auditory Brainstem Response (ABR), and Auditory Steady-state Response (ASSR), together with imaging studies such as Magnetic Resonance Imaging (MRI) and High-resolution Computed Tomography (HRCT). Management strategies involve the judicious use of antibiotics and corticosteroids, hearing aid fitting, and early cochlear implantation when indicated. Recommendation: all children after bacterial meningitis should undergo early audiological evaluation and regular follow-up to enable timely detection of cochlear ossification and to facilitate the development of an optimal intervention strategy.
Article Details
Keywords
Sensorineural hearing loss; bacterial meningitis; cochlear implantation
References
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15. Dutt SN, Mittal AA. Protocol for Evaluation and Management of Hearing Loss After Meningitis. Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):115-120
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19. Zeeshan M, et al. Correlation between OAEs and SNHL post meningitis. Int J Pediatr Otorhinolaryngol. 2018;112:85-90.
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21. Yan T, Zong F, Ma X, et al. Cochlear implantation in patients with ossified cochleas. Am J Otolaryngol. 2019;40(2):183-6.
22. Zhang N, Dong R, Zheng J, et al. Cochlear implantation for post-meningitis deafness with cochlear ossification: diagnosis and surgical strategy. Acta Otolaryngol. 2022; 142(5): 369-74.
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26. Teissier N, Blanchard M, Vieu A, et al. Imaging in postmeningitic deafness in children. Otol Neurotol. 2011;32(3):448-454s.
27. Sharma A, Dorman MF, Spahr AJ. A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation. Ear Hear. 2002;23(6):532-539
28. Singhal K, Singhal J, Muzaffar J, et al. Outcomes of cochlear implantation in patients with postmeningitis deafness: a systematic review and narrative synthesis. J Int Adv Otol, 2020;16(3):395-410.
29. Cabbarzade C, Polat B, Atan D, et al. Long-term auditory and speech outcomes of cochlear implantation in postmeningitic deafness: partial versus full electrode insertion. J Craniofac Surg. 2023;34(2):502-506.
30. Eisenman DJ, Ashman B, Hertzano R, et al. Cochlear implantation in children with postmeningitic labyrinthitis ossificans. Otol Neurotol. 2009;30(5):613-618.
31. Reilly PG, Papsin BC, Gordon KA. Incidence of cochlear ossification after bacterial meningitis in children. Otol Neurotol. 2015;36(3):e123-e130.
32. Wei BP, Robins-Browne RM, Shepherd RK. Can cochlear implantation prevent cochlear ossification after bacterial meningitis? Arch Otolaryngol Head Neck Surg. 2006;132(10):936-940.
33. Persson F, Bjar N, Hermansson A, et al. Hearing loss after bacterial meningitis, a retrospective study. Acta Otolaryngol, 2022;142(3-4):298-301
34. Rodenburg-Vlot MBA, Ruytjens L, Oostenbrink R, et al. Repeated audiometry after bacterial meningitis: consequences for future management. Otol Neurotol. 2018;39(5):e301-e306.
35. Merkus P, Free RH, Mylanus EA, et al. 4th Consensus in Auditory Implants Meeting. Dutch Cochlear Implant Group (CI-ON) consensus protocol on postmeningitis hearing evaluation and treatment. Otol Neurotol. 2010;31(8):1281-6
36. Teissier N, Doehring I, Noel-Petroff N, et al. Audiophonological evaluation of 16 children fitted with cochlear implants for sensorineural hearing loss induced by bacterial meningitis. Arch Pediatr. 2013;20(6):616-23.
37. Saha SK, Khan NZ, Ahmed AS, et al. Neurodevelopmental sequelae in pneumococcal meningitis cases in Bangladesh: a comprehensive follow-up study. Clin Infect Dis. 2009;48(2):90-6.
38. De Barros A, Roy T, Amstutz Montadert I, et al. Rapidly progressive bilateral postmeningitic deafness in children: diagnosis and management. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131(2):107-12.
39. Durisin M, Bartling S, Arnoldner C, et al. Cochlear ossification after bacterial meningitis in children: implications for cochlear implantation. Otol Neurotol. 2010;31(7):1078-1082.
2. Schmutzhard J, Glueckert R, Schmid S, et al. Pathophysiological mechanisms of hearing loss in pneumococcal meningitis. Acta Neuropathol. 2008;115(6):695-704.
3. Durisin M, Bartochowska A, Flanagin VL, et al. Sensorineural hearing loss in bacterial meningitis: a review. Int J Pediatr Otorhinolaryngol. 2010;74(6):649-654.
4. Huth ME, Ricci AJ, Cheng AG. Mechanisms of aminoglycoside ototoxicity and targets of hair cell protection. Int J Otolaryngol. 2011;2011:937861.
5. Zainel A, Mitchell H, Sadarangani M. Bacterial meningitis in children: neurological complications, associated risk factors, and prevention. Microorganisms, 2021;9(3):535
6. Karppinen M, Pelkonen T, Roine I, et al. Hearing impairment after childhood bacterial meningitis dependent on etiology in Luanda, Angola. Int J Pediatr Otorhinolaryngol. 2015;79(11):1820-6
7. Woolley AL, Kirk KA, Neumann AM Jr, et al. Risk factors for hearing loss from meningitis in children: the Children’s Hospital experience. Arch Otolaryngol Head Neck Surg. 1999 May;125(5):509-14.
8. Karanja BW, Oburra HO, Masinde P, et al. Risk Factors for Hearing Loss in Children following Bacterial Meningitis in a Tertiary Referral Hospital. Int J Otolaryngol. 2013;2013:354725.
9. Jatto ME, Adeyemo AA, Ogunkeyede SA, et al. Pediatric hearing thresholds post-bacterial meningitis. Front Surg, 2020;9(7):36.
10. Sarfraz M, Zahid J, et al. Frequency of Hearing Loss in Children after Acute Bacterial Meningitis. Pakistan Journal of Medical and Health Sciences. 2020;14:1104-1106.
11. Namani S, Milenković Z, Koci B. A prospective study of risk factors for neurological complications in childhood bacterial meningitis. J Pediatr (Rio J). 2013;89(3):256-62.
12. Brookhouser PE. Sensorineural hearing loss in children with bacterial meningitis. Ann Otol Rhinol Laryngol Suppl. 1994;163:54-58.
13. Trần Xuân Chương , Đoàn Quốc Đạt , Phan Trung Tiến. Nghiên cứu một số đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị viêm màng não do Streptococcus suis tại Bệnh viện Trung ương Huế năm 2011-2012. Tạp chí Y Dược học. 2012;46.
14. Jain S, Kundalwal A, Shakuntal G, et al. Risk factor for hearing loss from acute bacterial meningitis in infant. MedPulse Int J Pediatr. 2020;16(3):63-7.
15. Dutt SN, Mittal AA. Protocol for Evaluation and Management of Hearing Loss After Meningitis. Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):115-120
16. Jadia K, et al. Behavioral audiometry in children with meningitis. Indian J Otolaryngol Head Neck Surg. 2021;73(2):245-50.
17. Karppinen A, et al. ABR in prognosis of bacterial meningitis. Int J Pediatr Otorhinolaryngol. 2015;79(11):1884-90.
18. Roine I, et al. Evolution of hearing thresholds after BM. Pediatr Infect Dis J. 2013;32(6):682-6.
19. Zeeshan M, et al. Correlation between OAEs and SNHL post meningitis. Int J Pediatr Otorhinolaryngol. 2018;112:85-90.
20. Orman G, et al. MRI predictors of SNHL in infants with BM. Neuroradiology. 2019;61(3):257-64.
21. Yan T, Zong F, Ma X, et al. Cochlear implantation in patients with ossified cochleas. Am J Otolaryngol. 2019;40(2):183-6.
22. Zhang N, Dong R, Zheng J, et al. Cochlear implantation for post-meningitis deafness with cochlear ossification: diagnosis and surgical strategy. Acta Otolaryngol. 2022; 142(5): 369-74.
23. Van Ettekoven CN, van de Beek D, Brouwer MC. Update on community-acquired bacterial meningitis: guidance and challenges. Clin Microbiol Infect, 2017;23(9):601-6.
24. Wang Y, Liu X, Wang Y, et al. Meta-analysis of adjunctive dexamethasone to improve clinical outcome of bacterial meningitis in children. Childs Nerv Syst, 2018;34(2):217-23.
25. Esposito S, Semino M, Picciolli I, et al. Should corticosteroids be used in bacterial meningitis in children? Eur J Paediatr Neurol. 2013;17(1):24-8.
26. Teissier N, Blanchard M, Vieu A, et al. Imaging in postmeningitic deafness in children. Otol Neurotol. 2011;32(3):448-454s.
27. Sharma A, Dorman MF, Spahr AJ. A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation. Ear Hear. 2002;23(6):532-539
28. Singhal K, Singhal J, Muzaffar J, et al. Outcomes of cochlear implantation in patients with postmeningitis deafness: a systematic review and narrative synthesis. J Int Adv Otol, 2020;16(3):395-410.
29. Cabbarzade C, Polat B, Atan D, et al. Long-term auditory and speech outcomes of cochlear implantation in postmeningitic deafness: partial versus full electrode insertion. J Craniofac Surg. 2023;34(2):502-506.
30. Eisenman DJ, Ashman B, Hertzano R, et al. Cochlear implantation in children with postmeningitic labyrinthitis ossificans. Otol Neurotol. 2009;30(5):613-618.
31. Reilly PG, Papsin BC, Gordon KA. Incidence of cochlear ossification after bacterial meningitis in children. Otol Neurotol. 2015;36(3):e123-e130.
32. Wei BP, Robins-Browne RM, Shepherd RK. Can cochlear implantation prevent cochlear ossification after bacterial meningitis? Arch Otolaryngol Head Neck Surg. 2006;132(10):936-940.
33. Persson F, Bjar N, Hermansson A, et al. Hearing loss after bacterial meningitis, a retrospective study. Acta Otolaryngol, 2022;142(3-4):298-301
34. Rodenburg-Vlot MBA, Ruytjens L, Oostenbrink R, et al. Repeated audiometry after bacterial meningitis: consequences for future management. Otol Neurotol. 2018;39(5):e301-e306.
35. Merkus P, Free RH, Mylanus EA, et al. 4th Consensus in Auditory Implants Meeting. Dutch Cochlear Implant Group (CI-ON) consensus protocol on postmeningitis hearing evaluation and treatment. Otol Neurotol. 2010;31(8):1281-6
36. Teissier N, Doehring I, Noel-Petroff N, et al. Audiophonological evaluation of 16 children fitted with cochlear implants for sensorineural hearing loss induced by bacterial meningitis. Arch Pediatr. 2013;20(6):616-23.
37. Saha SK, Khan NZ, Ahmed AS, et al. Neurodevelopmental sequelae in pneumococcal meningitis cases in Bangladesh: a comprehensive follow-up study. Clin Infect Dis. 2009;48(2):90-6.
38. De Barros A, Roy T, Amstutz Montadert I, et al. Rapidly progressive bilateral postmeningitic deafness in children: diagnosis and management. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131(2):107-12.
39. Durisin M, Bartling S, Arnoldner C, et al. Cochlear ossification after bacterial meningitis in children: implications for cochlear implantation. Otol Neurotol. 2010;31(7):1078-1082.