Pneumococcal meningitis post cochlear implantation: preventative measures

Abstract

Objectives: Both clinical data and laboratory studies demonstrated the risk of pneumococcal meningitis post cochlear implantation. This review examines strategies to prevent post implant meningitis.

Data Sources: Medline search on topics related to pneumococcal meningitis post cochlear implantation.

Review Methods: Comprehensive analysis of the published clinical and scientific laboratory research data.

Results: The presence of inner ear trauma as a result of surgical technique or cochlear implant electrode array design was associated with a higher risk of post implant meningitis. Laboratory data demonstrated the effectiveness of pneumococcal vaccination in preventing meningitis induced via the haematogenous route of infection. Fibrous sealing around the electrode array at the cochleostomy site and the use of antibiotic coated electrode array reduced the risk of meningitis induced via an otogenic route.

Conclusion: The recent scientific data supports the FDA recommendation of pneumococcal vaccination for the prevention of meningitis in implant recipients. Non-traumatic cochlear implant design, surgical technique and an adequate fibrous seal around the cochleostomy site further reduce the risk of meningitis.