[91 dB hearing loss--the threshold for cochlear implant?]]

Recent indications for cochlear implant in children are bilateral total cochlear deafness and an age of 2 or more. Reports on successful implantations in adults with residual hearing pose the question of whether this indication might be expanded to children with residual hearing.

In a retrospective analysis of 106 hearing-impaired children with binaural amplification, we were able to ask parents in 90 cases about their children's education. The pure-tone average of the frequencies of 1-4 kHz was correlated to education.

The results showed that all children except one with a pure-tone average of < or = 90 dB could successfully attend regular school or kindergarten. However, those with a pure-tone average of > or = 91 dB had to be educated in special units for children with impaired hearing.

Our results indicate that amplification in children with profound hearing loss (pure-tone average > or = 91 dB) is not sufficiently effective to enable them to attend regular schools or kindergarten. We conclude that the only chance to integrate these children into the world of hearing might be cochlear implantation.