Cochlear Implants And Speech Skills Following
Meningitis
Editor: The more researchers study the use of cochlear implants (CIs)
in children, the more convinced they become that CIs are very effective,
and that the earlier a child receives his CI, the better. Here's a
confirming study on children who contracted Meningitis.
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A major research study funded by national charity Meningitis Research
Foundation conducted at the Nottingham Cochlear Implant Programme has just
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 centre 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, five 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 three 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.