Scala vestibuli cochlear implantation after meningitis

Abstract

We performed a scala vestibuli cochlear implantation for a deaf girl with ossified cochlear after meningitis. She was born uneventfully, and passed the new-born hearing screening. She suffered from bacterial meningitis at 5 months old, and 3 weeks later, was diagnosed with bilateral hearing impairment by auditory brainstem response (ABR) audiometry. Auditory steady-state response (ASSR) and conditioned orientation response (COR) audiometry confirmed profound bilateral deafness. Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) suggested ossification of the scala tympani, although the scala vestibule was normal. At 23 months, she underwent right-ear cochlear implantation. The scala tympani was completely occluded, but the lumen of the scala vestibule was patent. We were able to insert all electrodes into the scala vestibuli without resistance, and then the results of the neural response telemetry (NRT) were entirely positive. There were no postoperative complications, and the hearing threshold level with the cochlear implant was good.
Ossification of the cochlea is frequently observed after meningitis. It is important to detect the stage and the location of ossification by CT and MRI. In cases with ossification of the scala tympani, scala vestibuli cochlear implantation may be an effective treatment.