Post-cochlear implant meningitis

Cochlear implants have an excellent safety record and serious complications occur rarely. However, in recent years, we have become aware of an increase in the reported cases of meningitis in cochlear implant recipients. The cause of meningitis has not been established, but government agencies, device manufacturers, and cochlear implant teams across the world have taken significant actions to determine risk factors and to identify strategies for management and prevention. In the US, the CDC and the FDA have issued public warnings and are presently conducting an investigation into the apparent association between meningitis and cochlear implantation. The cause of meningitis in cochlear implant patients has not been conclusively determined, but some risk factors have been recognized: young age (<5 years), otitis media, history of pre-implantation meningitis, inner ear dysplasia, and device-specific factors. We discuss specific preventative strategies such as pre- and post-implantation identification of risk factors, surgical considerations, vaccination against most common organisms (ie, Streptococcus pneumoniae), prompt diagnosis and treatment of otitis media, and close auditing of cochlear implant practices.