CAUSING BACTERIAL MENINGITIS Cochlear Implants

Cochlear Implant Is a surgically implanted device that helps overcome problems in the inner ear, or cochlea.  Cochlea is a snail-shaped, curled tube located in the area of the ear where nerves are contained. Its function is to gather electrical signals from sound vibrations and transmit them to your auditory nerve (or hearing nerve).  The hearing nerve then sends these signals to the brain, where they're translated into recognizable sounds. If cochlea isn’t working properly and the hearing nerve isn't being stimulated, there's no way for the electrical signals to get to the brain. Therefore, hearing doesn't occur. By completely bypassing the damaged part of the cochlea, the cochlear implant uses its own electrical signals to stimulate the auditory nerve, allowing the person to hear.

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Who Gets Implants? Children and adults who are deaf or severely hard-of- hearing can be fitted for cochlear implants.  According to the Food and Drug Administration (FDA), as of April 2009  approximately 188,000 people worldwide have received implants.  41,500 adults and 25,500 children have received them. Most children who receive implants are between two and six years old.  Early implantation provides exposure to sounds that can be helpful during the critical period when children learn speech and language skills. In 2000, the FDA lowered the age of eligibility to 12 months for a cochlear implant.

Risks from the Surgical Implant Procedure Injury to the facial nerve Meningitis --this is an infection of the lining of the surface of the brain. People who have abnormally formed inner ear structures appear to be at greater risk of this rare, but serious complication. Cerebrospinal fluid leakage Perilymph fluid leak Infection of the skin wound. Blood or fluid collection at the site of surgery. Attacks of dizziness or vertigo. Tinnitus, which is a ringing or buzzing sound in the ear. Taste disturbances --the nerve that gives taste sensation to the tongue also goes through the middle ear and might be injured during the surgery. Numbness around the ear. Reparative granuloma --this is the result of localized inflammation that can occur if the body rejects the implant.

Recalls and Safety October 10, 2007  Public Health Notifications repeatedly warn about the increased, life-threatening risk of bacterial meningitis in cochlear implant recipients and the importance of fully immunizing them. September 24, 2004  Advanced Bionics Conducts Voluntary Recall of Cochlear Implants September 25, 2003  Risk of Bacterial Meningitis in Children with Cochlear Implants (FDA issues recommendations to decrease the risk of meningitis in cochlear implant recipients)

Meningitis Is an inflammation of the protective membranes covering the brain and spinal cord, known collectively as the Meningitis. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency. Meningitis is potentially life-threatening and has a high mortality rate if untreated; delay in treatment has been associated with a poorer outcome.

Symptoms of Meningitis  fever, headaches, stiff neck, nausea, vomiting, sensitivity to light, confusion  With treatment 10% die  20% have long-term disabilities, deafness, brain damage  out of 100,000 children get pneumococcal meningitis in the cohort which is 30 times higher than the rest of the population.  Those with implants with posistioners are more at risk than other children with other models of implants.  High risk continues up to 24 months after implantation.

Vaccines Two vaccines –  Menomune (MPSV4)  Menactra (MCV4) - is the preferred one  Both vaccines can prevent 4 types of meningococcal disease, including 2 of the 3 types most common in the United States and a type that causes epidemics in Africa.  Meningococcal vaccines cannot prevent all types of the disease. But they do protect many people who might become sick if they didn’t get the vaccine.  Both vaccines work well, and protect about 90 percent of those who get it. Menactra is expected to give better, longer-lasting protection.

How Many Doses? People 2 years of age and older should get 1 dose. (Sometimes an additional dose is recommended for people who remain at high risk. Ask your provider.) Menomune may be recommended for children 3 months to 2 years of age under special circumstances. These children should get 2 doses, 3 months apart.

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