Annelise: Cochlear Implants

On March 13, 2020, just as the country was starting to brace for the impact of COVID-19, the Frisco family, from Morgantown, Pa., was bracing for their own impact. Their youngest child, 4-month-old Annelise, was rushed to their local emergency department with a fever of 105 degrees. While being assessed, Annelise had a seizure and her blood pressure began dropping. Staff stabilized Annelise and quickly made the plan to have the Nemours Transport Team pick her up and take her to Nemours Children’s Hospital, Delaware in Wilmington, Del.

Nemours team races to save a little girl's life.

 “It was such a scary situation,” said Annelise’s mom, Kelsey. “But at the same time, from the minute we met the transport team to arriving at the Nemours emergency department, it immediately felt like we were in the right place.”

All throughout Annelise was becoming more lethargic and unresponsive. But finally they knew what they were dealing with — bacterial meningitis, a dangerous infection that causes swelling of the protective membranes covering the brain and spinal cord. Antibiotics were started immediately but Annelise also underwent surgery to release pressure on her brain. 

Another problem discovered.

About two weeks later, Annelise bounced back and was showing signs of her old, happy self. As they prepared for discharge she had one more round of tests to check for any hearing loss, a common complication of this serious infection. Sadly, it was confirmed that Annelise suffered profound hearing loss. And the discussion of cochlear implants then began.

Infants with profound hearing loss are usually implanted between 9 and 12 months of age, but an MRI concluded Annelise could not wait that long. “We had to move quickly,” explains Dr. Yell Inverso, director of Audiology at Nemours Children’s Hospital, Delaware. “The MRI showed that her inner-ear fluid had begun the process of turning to bone, a known complication of bacterial meningitis. If that process is completed, the benefit of an implant can be severely compromised and, at times, implantation is no longer possible.”

And so Annelise became the youngest patient ever at Nemours, at 4 months and 25 days old, to receive bilateral cochlear implants, and also one of the youngest in the country.

Precision and safe, quality care during a pandemic.

“Annelise’s situation was further complicated by the COVID-19 pandemic,” explained otolaryngologist Dr. William Parkes, medical director of the Cochlear Implant Program at Nemours Children’s Hospital, Delaware. “Resources were already restricted and there was concern that her surgery could pose a serious transmission risk to the team if she had been exposed to the virus. Fortunately, Annelise had been tested for COVID-19 and was known to be negative, allowing us to safely move forward with her surgery within days, minimizing the risk of inner ear bone formation altering our approach.”

Even activation day on April 28, 2020, was impacted by the pandemic. Due to visitation restrictions, only Annelise and mom Kelsey were able to be in the hospital. But via Zoom, her dad Ryan was able to participate. Ryan could see the moment when Annelise regained her hearing, and — just as important — Annelise could hear his voice.

“We knew this was going to be unlike any activation we had ever done,” said Dr. Inverso. “First we were returning sound to our youngest patient. Second we wanted to be sure dad was present for this important milestone. I think given the circumstances, things went better than we could ever have imagined.”