Chiến lược bảo vệ thính lực ở trẻ em sau viêm màng não nhiễm khuẩn
Nội dung chính của bài viết
Tóm tắt
Viêm màng não nhiễm khuẩn là bệnh lý nhiễm trùng cấp tính, tỉ lệ mắc cao ở trẻ em và có nguy cơ để lại nhiều di chứng thần kinh, trong đó phổ biến nhất là giảm thính lực tiếp nhận. Cơ chế gây tổn thương thính giác bao gồm viêm mê nhĩ do vi khuẩn xâm nhập từ khoang dưới nhện vào ốc tai; tắc động mạch mê nhĩ; thoái hóa tế bào lông do phản ứng viêm và độc tính của một số thuốc. Tổn thương có thể diễn biến nhanh dẫn tới xơ hóa và cốt hóa ốc tai, làm giảm khả năng phục hồi thính lực và ảnh hưởng đến hiệu quả cấy điện cực ốc tai. Chẩn đoán dựa vào các xét nghiệm đo thính lực: đo âm ốc tai (OAE - Otoacoustic Emissions), đo điện thính giác thân não (ABR - Auditory Brainstem Respond), đo đáp ứng trạng thái ổn định thính giác (ASSR - Auditory Steady State Response), kết hợp với chụp cộng hưởng từ (MRI - Magnetic Resonance Imaging) và chụp cắt lớp vi tính độ phân giải cao (HRCT - High Resolution Computed Tomography) tại ốc tai để phát hiện sớm tình trạng cốt hóa ốc tai. Các phương pháp điều trị bao gồm: sử dụng kháng sinh hợp lý, phối hợp corticosteroid sớm, sử dụng máy trợ thính, cấy điện cực ốc tai trong trường hợp giảm thính lực nặng-sâu không hồi phục. Khuyến nghị: Tất cả các trẻ sau viêm màng não cần được đánh giá thính lực sớm và theo dõi định kỳ nhằm phát hiện kịp thời tiến triển cốt hóa ốc tai để có chiến lược can thiệp tối ưu.
Chi tiết bài viết
Từ khóa
Giảm thính lực, viêm màng não nhiễm khuẩn, cấy điện cực ốc tai
Tài liệu tham khảo
1. Mook-Kanamori BB, Geldhoff M, van der Poll T, et al. Pathogenesis and pathophysiology of pneumococcal meningitis. Clin Microbiol Rev. 2011;24(3):557-591.
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.
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.