Late Otological Sequelae of Tuberculous Meningitis

Summary An otological follow‐up study in 1956 and 1959—62 of 103 children treated for and cured of tuberculous meningitis in 1949—54 is presented. Impaired hearing was observed in 63 per cent, severe loss of hearing in 15 per cent and total deafness in 7 per cent. In 36 per cent there was a hearing loss of more than 10 dB in the speech range (500—2,000 cps). The initial and the follow‐up results of otological investigations were in close accordance with each other — only in 3 cases was there some improvement and in 11 some deterioration of hearing. The cases with hearing loss were evenly distributed between the different age groups excepting the youngest one — 0—12 months — which displayed a considerably lower frequency of impaired hearing as a whole but a much higher frequency of severe hearing loss. There was no correlation between hearing sequelae and the duration of meningeal symptoms prior to hospitalization or the severity of the disease on admission. There was, however, a correlation between the frequency of hearing sequelae and the daily and total doses of streptomycin given: the frequency of hearing loss was 49 per cent (severe hearing loss 22 per cent) when 50 mg/kg daily was used compared with an incidence of 15 per cent (severe hearing loss in 4 per cent) when 10—20 mg/kg of streptomycin was used intramuscularly and 1—3 mg/kg intrathecally daily. No correlation was found between loss of hearing and neurological, mental, eye or EEG disturbances. Disturbances of vestibular function were found in 54 per cent altogether and they were severe in 31 per cent. Five of the 15 children with severe hearing loss used hearing aids with considerable success, 3 got along without them in ordinary schools and 10 children attended schools for the deaf.