Chronic Meningitis Due to Otitis Media With Cholesteatoma in a Five-Year-Old Child With a Cochlear Implant
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Cochlear implants (CIs) restore hearing in patients with severe-to-profound deafness. Post-CI meningitis is a rare but redoubted complication. We present the case of a five-year-old CI recipient who experienced an episode of chronic meningitis caused by chronic otitis media with cholesteatoma encasing the electrode lead. We hypothesize that the cholesteatoma led to an ascending infection to the cochlea, passing through the labyrinths, resulting in chronic meningitis. Although positive neural responses were initially noted on cochlear electrical stimulation, these responses resolved a few weeks after reimplantation. Our report highlights the importance of careful otoscopic examination and diagnostic work-up in patients presenting with otogenic meningitis to rule out cholesteatoma formation and to ensure prompt surgical exploration if warranted.
Abstract
Cochlear implants (CIs) restore hearing in patients with severe-to-profound deafness. Post-CI meningitis is a rare but redoubted complication. We present the case of a five-year-old CI recipient who experienced an episode of chronic meningitis caused by chronic otitis media with cholesteatoma encasing the electrode lead. We hypothesize that the cholesteatoma led to an ascending infection to the cochlea, passing through the labyrinths, resulting in chronic meningitis. Although positive neural responses were initially noted on cochlear electrical stimulation, these responses resolved a few weeks after reimplantation. Our report highlights the importance of careful otoscopic examination and diagnostic work-up in patients presenting with otogenic meningitis to rule out cholesteatoma formation and to ensure prompt surgical exploration if warranted.
참고문헌 (14)
- Rubin LG, "Cochlear implants in children : surgical site infections and prevention and treatment of acute otitis media and meningitis", Pediatrics, 126, pp.381~391 (2010)
- Lalwani AK, "Does meningitis after cochlear implantation remain a concern in 2011?", Otol Neurotol, 33, pp.93~95 (2012)
- Terry B, "Delayed complications after cochlear implantation", JAMA Otolaryngol Head Neck Surg, 141, pp.1012~1017 (2015)
- Manrique-Huarte R, "Surgical findings and auditory performance after cochlear implant revision surgery", Eur Arch Otorhinolaryngol, 273, pp.621~629 (2016)
- van Dijk B, "Clinical results of AutoNRT, a completely automatic ECAP recording system for cochlear implants", Ear Hear, 28, pp.558~570 (2007)
- Battmer RD, "International classification of reliability for implanted cochlear implant receiver stimulators", Otol Neurotol, 31, pp.1190~1193 (2010)
- Wei BP, "Can we prevent cochlear implant recipients from developing pneumococcal meningitis?", Clin Infect Dis, 46, pp.e1~e7 (2008)
- Wei BP, "Pneumococcal meningitis post-cochlear implantation : potential routes of infection and pathophysiology", Otolaryngol Head Neck Surg, 143(5 Suppl 3), pp.S15~S23 (2010)
- Wei BP, "Threshold shift : effects of cochlear implantation on the risk of pneumococcal meningitis", Otolaryngol Head Neck Surg, 136, pp.589~596 (2007)
- Lalwani AK, "Longitudinal risk of meningitis after cochlear implantation associated with the use of the positioner", Otol Neurotol, 32, pp.1082~1085 (2011)
- Gluth MB, "Prevention and management of cochlear implant infections", Cochlear Implants Int, 12, pp.223~227 (2011)
- Wei BP, "Pneumococcal meningitis post-cochlear implantation : preventative measures", Otolaryngol Head Neck Surg, 143(5 Suppl 3), pp.S9~S14 (2010)
- Schuknecht HF, "Pathology of the ear" (1974), Harvard University Press
- Hinojosa R, "Ganglion cell populations in labyrinthitis ossificans", Am J Otol, 12(Suppl), pp.3~7 (1991)