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J Audiol Otol > Epub ahead of print
DOI: https://doi.org/10.7874/jao.2022.00045    [Epub ahead of print] Published online September 19, 2022.
Chronic Meningitis Due to Otitis Media With Cholesteatoma in a Five-Year-Old Child With a Cochlear Implant
Hanneke D. van Oorschot1  , Hiske W. Helleman1,2  , Adriana L. Smit1,2 
1Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
2Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
Correspondence  Adriana L. Smit ,Tel: +31-88-757-3291, Email: a.l.smit-9@umcutrecht.nl
Submitted: February 18, 2022  Accepted after revision: July 20, 2022
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.
Keywords: Cochlear implantation; Meningitis; Chronic otitis media; Cholesteatoma
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