Evaluation of cochlear implantation in post-meningitic adults.

Meningitis is an important cause of deafness and in some studies has been associated with poorer outcomes in adult patients following cochlear implantation. Of the first 100 adults implanted under the Midland Cochlear Implant Programme, 28 were deafened as a result of meningitis. We compare our experience with these patients with patients with a non-meningitic aetiology. A degree of cochlear ossification was a more common finding in the meningitic group. In six cases (four meningitis, two non-meningitis) ossification was encountered only during surgery, not being apparent on pre-operative radiology. The average scores achieved on auditory tests by the meningitic group were similar to those achieved by non-meningitic patients. At nine months, using only the implant, users were able to identify 54 per cent of common environmental sounds, achieved an average score of 30 words per minute on connected discourse tracking and identified an average of 42 per cent of words correctly in BKB sentences. Poorer outcomes were more commonly associated with cochlear ossification. In patients with cognitive and neurological sequelae, benefits with the implant were not always apparent in the early months, however, with intensive therapy these patients can obtain measurable sustained benefit from their implant.