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Surgery and functional outcomes in deaf children receiving cochlear implants before age 2 years
S S Hehar1, Thomas P Nikolopoulos, Kevin P Gibbin
1Department of Otolaryngology, University Hospital, Queen's Medical Center NHS Trust, Nottingham, England.
Insights
Cochlear implantation is feasible in children under 2 years old, showing good surgical outcomes and functional hearing improvements comparable to older children. This early intervention offers significant benefits for pediatric hearing loss.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Neurosurgery
Background:
- Cochlear implantation is a critical intervention for severe to profound hearing loss in children.
- Early implantation is often recommended to maximize auditory development.
- Limited data exists on the feasibility and outcomes of cochlear implantation in very young children (under 2 years).
Purpose of the Study:
- To evaluate the surgical feasibility of cochlear implantation in children younger than 2 years.
- To assess the functional auditory outcomes in this pediatric population.
- To compare outcomes with those of children implanted between 2 and 5 years of age.
Main Methods:
- Prospective study at a tertiary pediatric cochlear implant center.
- 12 children under 2 years received multichannel cochlear implants (Nucleus C124M).
- Surgical complications and functional outcomes (Listening Progress Profile, Categories of Auditory Performance) were assessed.
Main Results:
- Cochlear implantation was surgically feasible with minimal complications.
- 11 of 12 patients achieved full electrode insertion; one required partial insertion.
- Functional outcomes at 2 years post-implantation were comparable to or better than those in children aged 2-5 years.
Conclusions:
- Cochlear implantation is a safe and effective procedure for children under 2 years old.
- Early cochlear implantation yields excellent functional hearing results.
- This supports the consideration of cochlear implantation in infants and very young children with hearing loss.
Objective:
To examine the feasibility of cochlear implantation in children younger than 2 years regarding surgery and functional outcomes.
Design:
Prospective study.
Setting:
Tertiary pediatric cochlear implant center.
Patients:
A consecutive sample of 12 children younger than 2 years at the time of cochlear implantation (8 boys and 4 girls). The cause of hearing loss was meningitis in 6 children and congenital in 6.
Interventions:
Multichannel cochlear implantation using the Nucleus C124M (Cochlear Co, Sydney, Australia) device. Functional outcome was assessed using the Listening Progress Profile and the Categories of Auditory Performance.
Main Outcome Measures:
Perioperative and postoperative surgical complications and functional outcome.
Results:
Eight children had a completely patent cochlea. Four children required a 3- to 5-mm drilling to reach the scala tympani because of ossification after meningitis. Full insertion was achieved in 11 patients; the other child received 18 electrodes. One patient had temporary facial nerve weakness; 2 others had wound edema and serous discharge that resolved with conservative management. In the longer term, 1 child experienced a single episode of acute otitis media; another had recurrent episodes of otitis media. Mean Listening Progress Profile scores increased from 1 to 42 and median Categories of Auditory Performance scores increased from 0 to 5 at 2 years postsurgery. Comparison with the scores in the 2- to 5-year group showed no significant differences. No significant tuning difficulties were experienced with all children.
Conclusions:
Cochlear implantation is feasible in children younger than 2 years without significant surgical complications or particular tuning difficulties. Functional results 2 years after implantation were as good as or better than those of children who underwent implantation between ages 2 and 5 years.