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Updated: Aug 19, 2026
Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Cochlear implant surgery at 12 months of age or younger
Adrian L James1, Blake C Papsin
1Department of Otolaryngology, Bristol Royal Hospital for Children, Bristol, UK.
Insights
Cochlear implantation surgery is safe for infants aged 7-12 months. A small incision technique and device fixation are recommended for optimal outcomes in young children receiving cochlear implants.
Area of Science:
- Pediatric Otolaryngology
- Auditory Implants
- Pediatric Neurosurgery
Background:
- Early cochlear implantation is increasingly performed in infants.
- The safety and feasibility of surgery in younger candidates require evaluation.
Purpose of the Study:
- To review the safety of cochlear implantation in children 12 months and younger.
- To assess mastoid bone anatomy and surgical outcomes in infants.
Main Methods:
- Analysis of case records and temporal bone CT scans in infants.
- Comparison of mastoid bone anatomy in infants versus older children.
Main Results:
- Twenty-five infants (7-12 months) received cochlear implants.
- Mastoid marrow content was greater in infants, but anatomy was adequate for surgery.
- No surgical complications occurred; all infants are full-time implant users.
Conclusions:
- Cochlear implant surgery is safe in infants (7-12 months) with proper support.
- A small incision technique is suitable for this age group.
- Device fixation is recommended due to the risk of displacement.
Objectives:
Early presentation of congenitally deaf children for cochlear implantation is leading to surgery in younger candidates. The safety of cochlear implantation in children aged 12 months and younger is reviewed with radiologic assessment of mastoid bone anatomy and surgical outcome data.
Study Design:
Analysis of case records and temporal bone computed tomography (CT) scans with description of surgical technique in infants.
Methods:
Chart analysis of children aged 12 months or younger at cochlear implantation. Mastoid bone anatomy was compared with older children (mean age 2 years) using CT scans.
Results:
Twenty-five infants received implants at 7 to 12 months of age because of meningitis (n = 4) or early detection of deafness (n = 21). Mastoid marrow content on CT scan was significantly greater in this age group (P < .001 Mann-Whitney rank sum test), but pneumatization was always adequate for safe identification of surgical landmarks. The smaller size of the mastoid bone was not restrictive. An extended postauricular approach was used in the first 11 cases and a 2.5 cm hair-line incision in the remainder. Ligature tie-down of the device was completed in all cases. No complications occurred. All are full-time implant users, except one with other neurologic sequelae of preoperative meningitis.
Conclusions:
In our experience, cochlear implant surgery is safe in children aged 7 to 12 months with appropriate anesthetic and postoperative support. The small incision technique is particularly suited to this age group. Ligature fixation of the device is considered advisable because of the increased risk of displacement from frequent falls when learning to walk.
