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 September 28, 2003
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Cochlear Implants and Bacterial Meningitis
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(Ivanhoe Newswire) -- A new study finds young children who underwent cochlear implants over a five-year period to restore hearing are at increased risk for bacterial meningitis caused by Streptococcus pneumoniae.

The increased incidence was most strongly linked to a positioning device that was routinely used in some of the surgeries and recalled by the Food and Drug Administration in July 2002. However, even children who had implants that didn't employ the positioning device were more likely than their peers to develop meningitis.

The study was spurred by reports of bacterial meningitis among children under age 6 who underwent the surgery. The disease was quickly linked to the use of a wedge-like device used to push the electrode in the implant against the wall of the cochlea, thus facilitating the transmission of the electrical signal. The device was recalled, but researchers decided to look at all children who received an implant between 1997 and 2002 to see if other risk factors could be identified as well.

The study uncovered 26 children with bacterial meningitis among about 4,200 children receiving the implants -- 30-times the incidence in the general population. The incidence for those whose surgery did not involved the recalled positioner was 16-times higher than normal. Other risk factors identified by the study were inner ear malformations and cerebrospinal fluid leaks.

The investigators conclude children receiving cochlear implants should be vaccinated against S. pneumoniae before surgery and followed carefully for any signs of infection.

About 10,000 American children have cochlear implants, which help them perceive sounds and make it easier for them to learn to speak.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

SOURCE: New England Journal of Medicine, 2003;349:421-423

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