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Audit of 5-year post-implantation routine integrity tests performed on paediatric cochlear implantees
1Department of Medical Physics, Queen's Medical Centre, Nottingham, UK.
Insights
Objective integrity testing (IT) is valuable for assessing cochlear implant function in young children, especially those with disabilities. This method complements behavioral testing for comprehensive pediatric cochlear implant management.
Area of Science:
- Audiology
- Biomedical Engineering
- Pediatric Medicine
Background:
- Cochlear implantation in children under 5 presents unique challenges for device monitoring.
- Young children, particularly those with additional disabilities, may struggle with traditional behavioral assessments.
- Objective measures are needed to ensure cochlear implant device integrity.
Purpose of the Study:
- To compare objective integrity testing (IT) with behavioral techniques for assessing cochlear implant function.
- To evaluate the utility of a 5-year post-implantation IT protocol.
- To determine the effectiveness of IT in identifying device faults in pediatric patients.
Main Methods:
- Compared objective IT (measuring electrical stimulus artefact) with behavioral threshold (T) and comfort (C) levels.
- Assessed 30 children aged 3-11 years, 5 years post-implantation with Nucleus Mini 22 devices.
- Proposed a 5-year post-implantation IT protocol examining common ground, monopolar, and bipolar modes.
Main Results:
- 43.3% of patients showed no electrode faults.
- 23.3% had potential faults detected by both IT and behavioral testing.
- 13.3% had faults detected only by IT, and 13.3% only by behavioral testing.
Conclusions:
- Integrity testing (IT) is a valuable tool for identifying faulty electrodes in pediatric cochlear implants.
- IT is particularly beneficial for young children and those with additional disabilities.
- Objective and behavioral techniques are complementary for managing pediatric cochlear implant patients.
Abstract:
The Nottingham Paediatric Cochlear Implant Programme (NPCIP) specializes in the implantation of children under 5 years of age. Subsequent tuning of the device and identification of changes in device function for these young children, who may have additional disabilities, can often be challenging. Thus, an objective measure to assess the integrity of the device is desirable. This study compares the device function by both objective and behavioural techniques in 30 children (age at implantation 3-11 years) at five years post-implantation. All children were implanted with the Nucleus Mini 22 device. Objective data were collected from integrity testing (IT) which allowed examination of the functioning of the implant by measuring the electrical stimulus artefact. This does not require the child to give a behavioural response. A protocol for a five-year post-implantation IT is suggested which examines common ground, monopolar and bipolar modes of operation. Behavioural data in the form of threshold (T) and comfort (C) levels were obtained by use of developmental age-appropriate techniques at 5 years post-implantation. Results demonstrate that 43.3% of patients had no electrode faults, 23.3% had potential faults on both behavioural and integrity testing, 6.7% were difficult to assess in terms of defining electrode faults due to partial electrode insertions, 13.3% had potential faults on behavioural testing only and 13.3% of patients had potential faults on IT only. In conclusion, IT is valuable in the identification of faulty electrodes, especially in young children and those with additional disabilities. Implementation of the five-year routine IT affected the management of 30% of patients. This study demonstrates that objective and behavioural techniques are complementary procedures in the ongoing management of paediatric patients.