A 2-year-old recovered from bacterial meningitis with resulting bilateral profound deafness. CT now shows partial ossification of the basal turn of the cochlea. Why must cochlear implantation not be deferred indefinitely in such children?

• A Implantation becomes technically impossible once the round window ossifies completely
• B The auditory cortex loses plasticity only after age 10
• C Progressive labyrinthitis ossificans obliterates the scala tympani, making electrode insertion progressively harder and poorer in outcome ✓
• D Repeated meningitis is inevitable without an implant

Explanation

Post-meningitic deafness leads to fibrosis followed by new bone formation within the scala tympani, termed labyrinthitis ossificans. As ossification advances, complete insertion of the electrode array becomes difficult or impossible and speech outcomes deteriorate, so early imaging and prompt implantation are advised. Cortical plasticity remains well into childhood, and the round window itself can be drilled open if needed.

Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.