Meningitis Risk in Patients with Inner Ear Malformations after Cochlear Implants

A Systematic Review and Meta-Analysis

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“Inner ear malformations are traditionally thought to be at high risk of post-operative meningitis following cochlear implantation. Our paper shows that the risk of meningitis after cochlear implantation in this group is low”, says Dr Shravan Gowrishankar, first author of the paper.

The following paper has been published by Otology and Neurotology - the official Journal of the American Otological Society and the American Neurotology Society.

Meningitis Risk in Patients with Inner Ear Malformations after Cochlear Implants: A Systematic Review and Meta-Analysis

Authors: Gowrishankar, Shravan; Fleet, Alex; Tomasoni, Michele†; Kuhn, Isla; Tysome, James; Smith, Matthew E.; Donnelly, Neil; Axon, Patrick; Borsetto, Daniele; Bance, Manohar

Cochlear implants (CIs) are surgically implanted devices that can improve hearing in those with severe to profound sensorineural hearing loss. By restoring sound perception, they also have wider effects on quality of life by reducing social isolation, anxiety, and depression in implanted patients (1).

However, as with any surgical intervention, there are potential complications associated with CIs. Minor complications often resolve spontaneously or with medical management, and range from dizziness to taste disturbance. Major complications may require revision surgery and/or hospitalization, and include device migration, electrode extrusion, and infections such as meningitis (2).

Meningitis is a rare but life-threatening complication linked to CIs that has received a significant level of attention. This concern stemmed from a large epidemiologic study in the early 2000s that found a higher risk of meningitis in those with CIs compared with the general population (3). In those receiving cochlear implantation, proposed risk factors include CIs with intracochlear positioners. However, the cause for this is not entirely known, with several etiologies being proposed, one of which includes positioner-induced modiolus trauma. Another proposed risk factor for postoperative meningitis includes the presence of inner ear malformations (IEMs) (3–5).

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