11-03-2006

A major research study funded by national charity Meningitis Research Foundation conducted at the Nottingham Cochlear Implant Programme has reported in Pediatrics—the official journal of the American Academy of Pediatrics—on the remarkable achievements of children deafened by meningitis.
Hearing loss is the most common long-term after effect of meningitis, affecting up to one quarter of survivors, and meningitis is the biggest cause of acquired deafness in children.

The study, led by Dr. Thomas Nikolopoulos, investigated long-term progress in speech skills of young children who were deafened by meningitis. These children lost their hearing very early in life, before they had learned to speak, and are so profoundly deaf that conventional hearing aids are of no use. All of them have surgically inserted cochlear implants, which bypass the damaged organ of hearing (the cochlea) and directly stimulate the auditory nerve, producing a sensation of hearing.

Taking place at Queens Medical Centre, Nottingham, which has the largest children’s cochlear implant center in the UK, the project compared long-term outcomes for these children in developing spoken language abilities to the same outcomes in implanted children who were born deaf.

The outcomes, 5 years after cochlear implantation, revealed that most children showed remarkable progress. Most (96%) could understand common phrases without lip-reading and 73% could understand conversation without lip-reading 3 years after implantation, whereas none of them could do so before implantation. Whilst the children’s speech was certainly improved following cochlear implantation, only 39% of the children developed very good speech skills within five years of the implant, suggesting that cochlear implantation has certain limitations or that the time period is not long enough for the children to reach their potential in this area.

The outcomes of the study support the further wide use of cochlear implants and will hopefully lead to improved cost-effectiveness of NHS funding of this procedure. But for cochlear implantation to be feasible, hearing tests are urgently needed as soon after meningitis as the child is well enough to be assessed, and certainly within 4 weeks of discharge from hospital. This is because in response to the inflammation caused by meningitis, bone may begin to grow in the inner ear that can make cochlear implantation impossible. The research team also stressed the need for children to be thoroughly assessed for additional disorders and difficulties, and for individually tailored training and support to be present, for children to reach their full potential.

[SOURCE: Medical News Today, October 2006]