Meningitis and Hearing Loss in Children
Meningitis is an inflammatory process, involving the leptomeninges within the subarachnoid space, if the infection spreads into the underlying brain; it is termed meningoencephalitis. Infectious meningitis can be broadly divided into acute pyogenic, aseptic, and chronic. (1) Bacterial meningitis is more severe than the viral and remains a serious cause of morbidity and mortality despite antibiotic therapy.(2) Examination of the CSF is often useful in distinguishing between various causes of meningitis.(1) Hearing loss usually divided into two types: (1) that caused by impairment of the cochlea or impairment of the auditory nerve, which is usually classified as “nerve deafness,” and (2) that caused by impairment of the physical structures of the ear that conduct sound itself to the cochlea,which is usually called “conduction deafness.”(3)
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Identifying hearing loss in children with bacterial meningitis and early recovery can lessen the children's long-term educational and social difficulties. Children underwent repeated audiological assessment with the first tests, being performed within six hours of diagnosis. By using a combination of otoacoustic emissions, auditory brain stem responses, and tympanometry the differences between cochlear, neural, and conductive defects were distinguished. All cases of hearing loss were evident at the time of the first assessment. In both the permanent sensorineural and reversible impairments the cochlea was identified as the site of the lesion. The sensorineural hearing loss developed during the earliest stages of meningitis. Permanent deafness was uncommon, but 10% of patients had an easily reversible cochlear impairment if the meningitis had been handled with early diagnosis promptly.
