Dutch Cochlear Implant Group (CI-ON) consensus protocol on postmeningitis hearing evaluation and treatment

Objective: One of the most devastating sequelae of bacterial meningitis is profound hearing loss or even deafness. Although cochlear implantation is able to restore (some) hearing abilities, obliteration due to fibrosis and especially calcification of the cochlea in the postmeningitis period is limiting the success rate of an implantation. A national consensus assembled in a postmeningitis follow-up protocol has to increase awareness and thus the chances of an early detection and possible intervention when profound hearing loss occurs. Setting: All cochlear implant (CI) centers of The Netherlands located in the 8 academic otorhinolaryngology and audiology departments of The Netherlands, gathered in the Dutch Cochlear Implant Group (CI-ON, Cochlear Implant Overleg Nederland). Intervention: A protocol proposed by 3 centers was sent to all other CI centers in The Netherlands to review and agree on. Main Outcome Measures: The CI centers agreed on the need for, and use of, the proposed protocol. Keystones of the protocol are treatment with dexamethasone before start of antibiotics, early magnetic resonance imaging and repeated audiological follow-up, and urgent referral to a CI center in all cases with greater than 30 dB SNHL. Conclusion: The Cochlear Implant Centers in The Netherlands (CI-ON) have agreed on a protocolized follow-up after bacterial meningitis to increase the chances of an early detection and possible intervention should profound hearing loss occur.

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