Progressive hearing loss following Haemophilus influenzae meningitis

doi:10.1016/S0165-5876(85)80041-0

International Journal of Pediatric Otorhinolaryngology

Volume 9, Issue 3, August 1985, Pages 249-256

https://doi.org/10.1016/S0165-5876(85)80041-0 Get rights and content

Summary

Loss of hearing is a sequelae of meningitis. This hearing loss has been known to fluctuate for as long as one year following the acute infection. This paper presents a case of an 11-year documented downward fluctuating hearing loss following Haemophilus influenzae meningitis. The case indicates that patients should be followed audiologically for years following meningitis.

A review of the literature of hearing loss in meningitis is presented with special emphasis on cases in which the hearing loss fluctuated. The cases in the literature were usually not followed for more than one year.

In this case of acquired hearing loss secondary to Haemophilus influenzae meningitis, the patient's hearing fluctuated over 11 years, in a downward progression. It is not clear what type of mechanism is involved in the ongoing damage to the cochlea that could account for this gradual fluctuation. It is suggested that as the possibility of long-term fluctuation exists, patients with meningitis should be monitored audiologically for many years.

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Cited by (18)

Postmeningitic pediatric hearing loss from non-type b Haemophilus influenzae
2024, American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Postmeningitic hearing loss from Haemophilus influenzae (H. influenzae) is increasingly due to encapsulated serotypes other than type b (Hib) and nontypeable strains (collectively, nHiB H. influenzae). Pediatric hearing loss after nHib H. influenzae meningitis remains poorly described.
Retrospecive case series of nHiB H. influenzae meningitis cases identified from a microbiologic database at Children's Hospital Colorado from 2000 to 2020. Literature regarding nHiB H. influenzae and H. influenzae postmeningitic hearing loss was also reviewed.
Eleven cases of nHib H. influenzae meningitis (median age 15.9 months) were identified due to serotype f (36 %), serotype a (27 %), and nontypable strains (36 %). Seven (64 %) patients were male, 55 % were white and 18 % were Hispanic or Latino. Hearing loss was initially identified in 4 children (40 %), with two patients with moderate conductive hearing loss (CHL) and one child with unilateral moderate sensorineural (SNHL) hearing loss patients recovering normal hearing. One patient with bilateral profound sensorineural hearing loss and associated labyrinthitis ossificans required cochlear implantation. All children (4) with identified hearing loss were noted to have additional intracranial sequelae, which included empyema (2), sinus thrombosis (2), and seizures (2). Of patients receiving steroids, 25 % had hearing loss on initial testing, compared to 66 % of those who did not receive steroids.
nHib H. influenzae can cause both transient and permanent postmeningitic hearing loss. Steroids may offer otoprotection in nHib H. influenzae meningitis similar to Hib meningitis. Given the limited literature, further study is needed to better characterize hearing outcomes after nHib H. influenzae meningitis.
Double challenge: cochlear implantation in the only hearing ear with progressive hearing loss following meningitis and vestibular dysfunction after implantation
2020, Journal of Otology
Citation Excerpt :
Fluctuating of hearing could be associated with endolymphatic sac destruction. Silkes and Chabot have reported an 11-year documented fluctuating but downward progression of hearing loss following meningitis (Silkes and Chabot, 1985). Durisin et al. have reviewed computed tomographic findings of 126 patients with profound hearing loss due to meningitis and have reported increased rate of osteoneogenesis over time after meningitis (Durisin et al., 2010).
Vestibular dysfunction associated with cochlear implantation is rare. It is usually seen in patients with otosclerosis due to spread of electrical activity throughout the demineralized bone. A 17-year old female with progressive hearing loss 2 years after meningitis and vestibular dysfunction in the implanted ear is presented in this study.
The patient had mild hearing loss in the right ear and total hearing loss on the left side because of complete ossification of the cochlea following meningitis. She had to have cochlear implantation in the right ear because of progression of hearing loss. She had successful implantation but she experienced vestibular dysfunction following activation of cochlear electrodes. Closure of two electrodes caused disruption of auditory programming. Then the patient was subjected to long term vestibular rehabilitation program.
Timing for implantation before the completion of cochlear ossification is crucial not to miss the chance for hearing restoration. However, difficulties in hearing rehabilitation due to extensive ossification can be doubled by vestibular problems triggered by stimulation of the vestibular nerve by cochlear electrodes. Attempts to reduce the balance problem will complicate auditory programming. Vestibular rehabilitation for long term helps to carry on hearing progress.
Children deafness: Classification and treatment
2005, EMC - Oto-Rhino-Laryngologie
La surdité de l'enfant empêche l'acquisition normale du langage et de la parole. On peut proposer une classification des surdités de l'enfant selon le côté de l'atteinte, le seuil audiométrique tonal, le mécanisme de la surdité, l'âge d'apparition de la surdité, le caractère syndromique ou non syndromique de la surdité, et l'existence d'un handicap associé. Les facteurs qui influencent la prise en charge sont la forme de la courbe audiométrique, l'évolutivité de la surdité, les caractéristiques de la famille, mais surtout l'âge de la prise en charge, encore trop tardif en France. La prise en charge des déficiences auditives sévères ou profondes repose sur la réhabilitation du canal auditif (prothèses conventionnelles ou implant cochléaire), sur la rééducation orthophonique, sur les aides à la communication et les modes de communication annexes, et sur le soutien éducatif. La prise en charge des déficiences auditives moyennes dépend du mécanisme lésionnel : appareillage auditif, rééducation orthophonique, soutien éducatif en cas de surdité de perception ; traitement de la cause, rééducation orthophonique en cas de surdité de transmission. Les surdités unilatérales vont avoir un impact très modeste sur le langage et la scolarité et doivent bénéficier d'une surveillance.
The language development is impaired in the deaf child. A classification of child deafness is proposed according to the sidedness of deafness, auditory thresholds, deafness mechanism, age at onset, the syndromic or non syndromic feature, and presence of associated disability. The major prognostic factor for language development is the age at treatment initiation. The treatment of profound or severe deafness includes auditory rehabilitation using hearing aids or cochlear implant, speech therapy, using of extra auditory communication modes, and an educational support. The treatment of mild deafness depends on the aetiology of the deafness. Unilateral deafness may have little effects on child development, and should be watched over.
Otologic and Neurotologic Sequelae of Meningitis
2005, Neurotology
Progressive hearing loss in hearing impaired children: Immediate results of antiphlogistic-rheologic infusion therapy
2001, International Journal of Pediatric Otorhinolaryngology
Objective: The question whether progressive sensorineural hearing loss during childhood is the fateful course of a main illness has been discussed controversially over 60 years. No medicamentous therapy with satisfactory results has been described in the literature. The goal of this study was to determine whether an infusion therapy, developed for the treatment of sudden hearing loss in the elderly, can induce recovery after progression in sensorineural hearing loss during childhood. Methods: Out of 20 children suffering from acute progression in sensorineural hearing loss, seven children were treated with an infusion therapy containing prednisolone, pentoxifylline and a plasma expander (group I), and 13 children were not treated (group II). All children were advised not to use hearing aids for 6 weeks. Results: In group I, we observed partial to complete restoration of hearing threshold towards the original hearing threshold given by previous routine controls in 6/7 children. In group II, only three children recovered, with the state of ten children's’ hearing loss remaining unchanged. The long-term follow-up, however, showed no distinct difference in either group. Conclusion: Infusion therapy can be helpful when treating acutely progressing sensorineural hearing loss during childhood. The benefit for communicative competence has to be discussed. Further studies should be conducted.
Familial hereditary progressive sensorineural hearing loss among Saudi population
1995, International Journal of Pediatric Otorhinolaryngology
Clinical and audiological studies of 234 Saudi patients from the central area of Saudi Arabia with progressive sensorineural hearing loss were carried out in Riyadh. One hundred and sixty-four came from 38 families, i.e. 70% of the total and 30% were sporadic cases. Consanguinity was found in 80.8%. Their hearing loss was characterized as being bilateral sensorineural, starting at 1 kHz frequency and gradually sloping the pure tone audiogram to severe and profound hearing loss at 8 kHz. Special tests for recruitment indicate hair cell lesions. Caloric tests were normal in 56 patients tested. No abnormal internal ears were found in a C.T. scan done for 84 cases. Serology for TORCH and non-TORCH agents were done for (124) selected cases. Syphilis was negative, however, positive immunoglobulins for cytomegalovirus, herpes simplex type 1 and 2, and toxoplasmosis were seen in 52 cases. All patients came from one area called Qassim where old customs and the tradition of consanguineous marriage were still practiced. Some of these families are now under molecular and cytogenetic study.

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Progressive hearing loss following Haemophilus influenzae meningitis

Summary

J. Pediatr.

Meningitis in children and its effect on the action of the inner ear

Acta Otolaryngol.

Bacterial meningitis and sensorineural hearing loss: a prospective investigation

Laryngoscope

Abnormalities of the auditory brainstem response in post-meningitis infants and children

Int. J. Pediatr. Otorhinolaryngol.

The Causes of Profound Deafness in Childhood

Reversible hearing loss after meningitis

Ann. Otol. Rhinol. Laryngol.

Meningitis and hearing loss in children

Arch. Otolaryngol.