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Bacterial meningitis secondary to stapes footplate malformation in a child with an auditory brainstem implant

Published online by Cambridge University Press:  06 October 2011

M Mandalà  and
L Colletti
M Mandalà*
Affiliation:
ENT Department, University of Verona, Italy
L Colletti
Affiliation:
ENT Department, University of Verona, Italy
*
Address for correspondence: Dr Marco Mandalà, Piazzale L A Scuro 10, 37134 Verona, Italy Fax: +39 045802749 E-mail: marcomand@hotmail.com
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Abstract

Objective:

We report a rare presentation of otogenic bacterial meningitis secondary to a stapes footplate malformation in a paediatric patient with an auditory brainstem implant.

Case report:

A patient with Mondini's dysplasia developed meningitis six years after auditory brainstem implantation. The aetiology was believed to be otogenic, secondary to stapes footplate malformation.

Conclusion:

To our best knowledge, this is the first report of otogenic bacterial meningitis secondary to stapes footplate malformation in a paediatric patient with an auditory brainstem implant. Subjects with inner ear malformations, especially Mondini's dysplasia, need to be carefully evaluated pre-operatively to reduce or eliminate any anatomical conditions which may predispose to meningitis. In children with an auditory brainstem implant and suspected ear malformation, we recommend pre-operative radiological investigation to look for the ‘bulging oval window’ sign. When radiological signs are positive, bilateral exploratory tympanotomy should be performed to detect any undiagnosed anatomical stapes footplate defects, which may predispose to bacterial meningitis.

Keywords

StapesChildMeningitisOtitis MediaAuditory Brain Stem Implants
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 1 , January 2012 , pp. 72 - 75
Copyright
Copyright © JLO (1984) Limited 2011

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