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Wei BP, Shepherd RK, Robins-Browne RM, Clark GM, O'Leary SJ. Pneumococcal meningitis post-cochlear implantation: Preventative measures. Otolaryngol Head Neck Surg 2010. [DOI: 10.1177/019459981014305s08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective 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/PubMed database; English articles after 1980. Search terms: cochlear implants, pneumococcus meningitis, streptococcus pneumonia, immunization, prevention. Review Methods Narrative review. All articles relating to post-implant meningitis without any restriction in study designs were assessed and information extracted. 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 hematogenous 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 support the U.S. Food and Drug Administration recommendation of pneumococcal vaccination for the prevention of meningitis in implant recipients. Nontraumatic cochlear implant design, surgical technique, and an adequate fibrous seal around the cochleostomy site further reduce the risk of meningitis.
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Affiliation(s)
- Benjamin P.C. Wei
- Bionic Ear Institute and the Department of Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia
| | - Robert K. Shepherd
- Bionic Ear Institute and the Department of Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia
| | - Roy M. Robins-Browne
- Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia
| | - Graeme M. Clark
- Bionic Ear Institute and the Department of Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen J. O'Leary
- Bionic Ear Institute and the Department of Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia
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Wei BPC, Robins-Browne RM, Shepherd RK, Clark GM, O'Leary SJ. Can We Prevent Cochlear Implant Recipients from Developing Pneumococcal Meningitis? Clin Infect Dis 2008; 46:e1-7. [DOI: 10.1086/524083] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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