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Preventing Labyrinthitis Ossificans
The Role of Steroids
Christopher J. Hartnick, MD;
Hank Y. Kim, MD;
Patricia M. Chute, EdD;
Simon C. Parisier, MD
Arch Otolaryngol Head Neck Surg. 2001;127:180-183.
Objective To identify a possible relationship between the administration of steroids
at the time of diagnosis of bacterial meningitis and the development of labyrinthitis
ossificans.
Design Retrospective analysis of the charts of 38 children requiring cochlear
implantation who presented with bacterial meningitis and then developed bilateral
profound deafness. The patients' charts were reviewed for age at diagnosis,
the type of antibiotic administered, and the administration, dosage, and duration
of steroid (dexamethasone) therapy. Labyrinthitis ossificans was established
by preoperative computed tomographic and/or magnetic resonance imaging and
by the intraoperative findings as described in the operative report.
Patients and Methods Patients were 38 children who received cochlear implantation by a single
senior otolaryngologist for bacterial meningitis–related deafness. Ten
patients' charts (26%) were available for full review; 9 of these 10 patients
had documented pneumococcal meningitis and the other patient had Haemophilus influenzae–type meningitis.
Results One of the 6 patients who received steroid therapy at the time of initial
illness had documented evidence of labyrinthitis ossificans either radiographically
or at the time of surgery. All 4 patients who failed to receive steroid therapy
developed labyrinthitis ossificans. The results achieve statistical significance
by  2 analysis and a t test (P<.01).
Conclusion The results of this retrospective study are highly suggestive of a role
for steroids in preventing the development of labyrinthitis ossificans in
children with pneumococcal meningitis.
From the Department of Pediatric Otolaryngology, Children's Hospital
Medical Center, Cincinnati, Ohio (Dr Hartnick); Department of Otolaryngology,
Montefiore Medical Center, Bronx, NY (Dr Kim); and the Cochlear Implant Center,
New York, NY (Drs Chute and Parisier).
Corresponding author: Christopher J. Hartnick, MD, Department of
Pediatric Otolaryngology, Children's Hospital Medical Center, 3333 Burnet
Ave, Cincinnati, OH 45229 (e-mail: harq4k{at}chmcc.org).
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