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Updated: Aug 23, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
The influence of potentially limiting factors on paediatric outcomes following cochlear implantation
Sanja Vlahović1, Branka Sindija
1Polyclinic for Rehabilitation of Hearing and Speech SUVAG, Kneza Ljudevita Posavskog 10, HR-10000 Zagreb, Croatia. sanja.vlahovic@hi.hinet.hr
Insights
Cochlear implantation benefits children even with additional challenges like cochlear malformations or reimplantation. However, retrocochlear pathology significantly hinders outcomes, emphasizing the need for comprehensive success evaluation beyond auditory measures.
Area of Science:
- Pediatric Otolaryngology
- Auditory Rehabilitation
- Speech-Language Pathology
Background:
- Cochlear implantation (CI) offers significant benefits for children with severe to profound hearing loss.
- Outcomes can be influenced by pre-existing conditions beyond isolated hearing impairment.
- Assessing CI success requires understanding factors impacting postoperative performance.
Purpose of the Study:
- To evaluate the impact of limiting factors on cochlear implant outcomes in children.
- To analyze performance in children with additional disabilities, cochlear malformations, ossification, or retrocochlear pathology.
- To assess outcomes in children undergoing reimplantation.
Main Methods:
- Study included 11 children across four groups: additional disabilities, cochlear malformation/ossification, reimplantation, and retrocochlear pathology.
- Evaluated hearing, speech perception, and production using standardized audiometric and speech tests.
- Assessed subjective positive life changes via a questionnaire.
Main Results:
- Children with additional disabilities showed better perception than expected but less satisfactory speech development.
- Cochlear malformations/ossification led to good sound perception but poor understanding.
- Reimplantation allowed for optimal rehabilitation, while retrocochlear pathology yielded unsatisfactory results.
Conclusions:
- Most children, excluding those with retrocochlear pathology, benefited considerably from cochlear implantation despite challenging conditions.
- Heterogeneity within groups necessitates individualized outcome assessment.
- Subjective indicators of life changes are crucial for evaluating success, particularly in children with multiple handicaps.
Objective:
Children with isolated hearing impairment who have received cochlear implant at the optimal age mostly achieve remarkable results that are assessed by objective speech perception and production measurements. Different outcomes may be expected in case of conditions which may have a negative impact on postoperative performance. The aim of this study was to assess the influence of potentially limiting factors on postimplant outcomes.
Methods:
Four groups of examinees (11 in total) were involved by the study: (A) four children with additional disabilities, (B) three children with cochlear malformation and/or ossification, (C) three reimplanted children, (D) a child with retrocochlear (cochlear nerve) pathology. Hearing, speech perception and production were examined by pure tone audiogram, speech audiogram, categories of auditory performance, speech intelligibility rating, listening progress profile, and monosyllabic trochee polysyllable test. Postoperative positive life changes were assessed by a questionnaire.
Results:
Group A: perception skills better than expected, less satisfactory speech development. Group B: good sound perception, poor understanding. Group C: after reimplantation undisturbed conditions for continuation of optimal rehabilitation course. Group D: unsatisfactory results of pure tone hearing as well as speech perception and production.
Conclusion:
In spite of unfavourable conditions all examinees, except a child with retrocochlear pathology, were found to have a considerable benefit after cochlear implantation (with regard to obvious heterogeneity within each group). Evaluation of success, especially in children with multiple handicaps, also has to include subjective indicators of positive life changes, even those not directly associated with hearing.
