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Objective: This study aimed to investigate whether children with cochlear implants received the recommended vaccinations according to New Zealand national immunisation guidelines and to report the incidence of meningitis in this population after intervention., Method: A retrospective review of the vaccination coverage of paediatric patients receiving cochlear implants between 2005 and 2019 was performed., Results: Data were collected on 203 children. Evidence of immunisation against Haemophilus influenza B was documented in 94.1 per cent of this cohort and 21.2 per cent received the seasonal influenza vaccine. The pneumococcal conjugate vaccine was fully administered in 81.8 per cent of children; however, only 16.9 per cent of eligible children had received the pneumococcal polysaccharide vaccine . There was marked improvement in compliance to the pneumococcal conjugate vaccine once it became fully funded for cochlear implant patients., Conclusion: Despite established guidelines, the paediatric vaccination rates were less than expected. Work is in progress to address this.

Aim: To investigate if adult cochlear implant (CI) recipients have received the recommended immunisations as compared to current guidelines and to report instances of meningitis within this population., Methods: Telephone interview of CI recipient's general practitioner (GP) surgeries for details regarding immunisations received. Subsequent reporting of immunisation rates of adult patients, under the care of the Northern Cochlear Implant Programme (NCIP) in New Zealand, when compared to the recommended guidelines from the Immunisation Advisory Centre (IMAC) and rates of meningitis of CI recipients are presented., Results: It is recommended to immunise against the most common organisms causing meningitis, Streptococcus pneumoniae and Haemophilus influenzae type b (HiB), as well as influenza. Data for 135 CI recipients over the last five years was complete. 14.8% of patients had received a full pneumococcal immunisation schedule. 11.9% had received a HiB immunisation and 62.2% an influenza vaccination. No patient had developed meningitis following CI insertion., Conclusion: This paper highlights clear issues with the immunisation of adult CI recipients., Competing Interests: Dr Neeff is the chairperson of the Northern Cochlear Implant Programme Advisory Group. The Northern Cochlear Implant Programme (NCIP) is a publicly funded programme for profoundly deaf children and adults in the northern region of New Zealand.

Objectives: To study the changes in behavioural and cortical responses over time in a child with single-sided deafness fitted with a cochlear implant (CI)., Methods: Cortical auditory evoked potentials (CAEPs) in noise (+5 dB signal-to-noise ratio) were recorded and auditory skills were assessed using tests of sound localization, spatial speech perception in noise, and self-ratings of auditory abilities (Listening inventory for education, LIFE and Speech, spatial and qualities of hearing questionnaire, SSQ parental version). Measures were obtained prior to and after a CI fitting, including one, six, and 12 months after the CI switch on., Results: Spatial speech recognition improved over time. At 12 months post-CI, word recognition scores were similar to those of normal hearing children. Signal-to-noise ratios for sentences decreased (i.e. improved) over time post-CI. Sound localization markedly improved at 12 months post-CI compared to baseline. Self-perception of difficulty scores decreased over time. Parental ratings of hearing abilities improved compared to baseline for all subscales. There were changes in the P1-N1-P2 complex at 12 months post-CI, which were clearer frontally across stimuli. Further research is needed to understand the significance of such changes after CI fitting for single-sided deafness., Conclusion: Although the changes observed could reflect maturational changes, the clinically significant improvement in recognition of speech in noise and improved questionnaire results suggest that the CI was beneficial, consistent with the feedback from the participant.

Objective: The aim of this study was to examine the effect of cochlear implant (CI) site infection and its subsequent management on CI mapping and CI performance. Risk factors for CI infections and pathogens causing infections were reviewed. Treatment options for CI infections were examined., Study Design: Retrospective case review., Setting: Tertiary referral center., Patients: Adult patients with a significant CI soft tissue infection from the Northern Cochlear Implant Programme, New Zealand over a 10-year period (August 2004 until August 2014)., Intervention: Patients were treated with intravenous antibiotics, washout and debridement or ex-plantation and reimplantation of CI., Main Outcome Measure: CI mapping results and implant performance before and after management of CI infections were compared., Results: There were nine CI infections. Most patients (7/9) were treated with washout and debridement. One patient required removal of the CI and one patient was deemed medically unfit for a general anaesthetic and was managed conservatively with antibiotics alone. Seven patients received long-term antibiotics. Four patients were able to maintain CI performance after salvage treatment of the CI infection. Three patients had poorer CI performance after salvage treatment. One patient had reimplantation and became a nonuser due to only partial reinsertion., Conclusion: The pathophysiology of CI infections is complex. Infections can occur many years after CI surgery. The most common bacteria identified were Staphylococcus aureus, Pseudomonas aeruginosa, and skin commensals. Biofilms are present around implants that are removed from patients and biofilms may play a role in CI infections, but the mechanism of infection is not clear.