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Letters to the Editor
Oct 2011

To Avoid Delay and Optimize Magnetic Resonance Imaging in Postmeningitic Hearing Loss—Reply

Author Affiliations

Author Affiliations: Division of Pediatric Otolaryngology, Section of Otology and Neurotology (Dr Young), and Department of Infectious Diseases (Dr Tan), Children's Memorial Hospital, Chicago, Illinois.

Arch Otolaryngol Head Neck Surg. 2011;137(10):1052-1053. doi:10.1001/archoto.2011.160

In reply

Merkus and colleagues raise a number of important points regarding the potential sources of delay that may hinder timely implantation in children with postmeningitic deafness. Of the 5 children described in our article, 3 were treated for bacterial meningitis at outlying hospitals. These children did not undergo hearing evaluation until after hospital discharge. At discharge, the importance of timely diagnosis of deafness and, in particular, the potential need for urgent cochlear implantation were not explained to the parents. In each case, the local audiologist or otolaryngologist who subsequently diagnosed profound hearing loss did recognize the need for cochlear implant evaluation, although the potential urgency was not understood by all families. Therefore, the rapidity by which parents contacted our implant program was variable. Education to increase awareness of pediatric medical specialists and primary care physicians about the need for rapid diagnosis of hearing loss and cochlear implant referral for these children would be advantageous. Similarly, it is extremely important that otolaryngologists and audiologists continue to be reminded about the potential need for urgent implantation of children deafened by meningitis. The development of stringent inpatient and discharge protocols that ensure the completion of hearing evaluation in a timely manner would be of benefit.

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