Cochlear turns measurements in patients with meningitis: Ahistopathological study

Henrique F. Pauna MD | Michael M. Paparella M | Sebahattin Cureoglu MD1 | Miguel A. Hyppolito MD, PhD

Abstract

Objective: To demonstrate the cochlear turns area changes among patients with a history of meningitis, through otopatologic study.

Methods: We performed an analysis of the area of the bony cochlear turns and the cochlear lumen of the horizontal sections containing the modiolus and the area of the basal turn at the level of round window, in temporal bones obtained from patients with a history of meningitis and compared to a nondiseased control group.

Results: The mean area of the bony walls and the lumen of all cochlear turns are reduced within the meningitis group. Patients who presented a time from the diagnosis of meningitis to death longer than 30 days had a significant reduction in the cochlear turns area, as compared to the control group.

Conclusion: Future studies may further correlate audiologic outcomes, cochlear volume, and cochlear area among patients with meningitis.

INTRODUCTION

Bacterial meningitis is a major cause of profound sensorineural hearing loss in children, with prevalence ranging from 60% to 90%. Bacterial infection in the subarachnoid space usually reaches the cochlea through the cochlear aqueduct but may also reach the cochlea through adjacent structures, often causing irreversible damage within inner ear structures. As a result, labyrinthitis ossificans can be seen in the otic capsule in response to the inflammatory process.

Cochlear ossification is known as a pathological process. Preoperative imaging by computed tomography (CT) is mandatory for preoperative planning. A retrospective review of preoperative CT scans performed among 34 candidates with bilateral hearing loss following meningitis found cochlear ossification in 35% of them. Using a highresolution CT scan of 15 ears, from 13 patients with profound hearing loss following meningitis, Ichikawa et al found soft tissue, partial bony occlusion, and complete bony occlusion in 3, 2, and 6 ears, respectively.

Despite of the tomographic demonstration of labyrinthitis ossificans, the literature is scarce to demonstrate, histopathologically, the differences of bony cochlear area and cochlear lumen area among patients with a history of meningitis. Therefore, in this otopathologic study, our aim is to present cochlear area measurements along the modiolus and round window in a group of patients with a history of meningitis.

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