Related Experiment Video
Updated: Aug 19, 2026
Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
Cochlear implantation at under 12 months: report on 10 patients
Vittorio Colletti1, Marco Carner, Veronica Miorelli
1ENT Department, University of Verona, Verona, Italy. vittoricolletti@yahoo.com
Insights
Very early cochlear implantation (CI) in infants with profound congenital hearing loss significantly improves auditory performance and language skills. This study found that CI as early as 4-6 months leads to outcomes comparable to those of normally hearing children.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Developmental Pediatrics
Background:
- Profound congenital hearing loss (CHL) significantly impacts auditory and language development in children.
- Early cochlear implantation (CI) is crucial for optimal auditory performance and language acquisition.
- Advances in audiology and CI safety have led to earlier implantation ages.
Purpose of the Study:
- To evaluate the efficacy of very early cochlear implantation (4-6 months) in infants with profound CHL.
- To assess the impact of early CI on auditory performance and speech development.
- To compare outcomes in very early implanted children with older children and normally hearing peers.
Main Methods:
- A cohort of 10 infants (4-11 months) received cochlear implants (Nucleus CI 24 M).
- Auditory performance was assessed using the Category of Auditory Performance (CAP) scale.
- Speech development, including babbling onset and spurt, was compared to a control group of normally hearing children.
Main Results:
- Surgery was uneventful with no complications.
- All infants achieved a CAP score of 3 within 6 months post-activation.
- Early CI demonstrated a positive impact on babbling onset and spurt, with results approaching those of normally hearing children.
Conclusions:
- Very early cochlear implantation (4-6 months) is recommended to optimize developmental processes during the critical language acquisition period.
- Early CI facilitates the normalization of audio-phonologic parameters.
- Outcomes in very early implanted children suggest performance similar to their normally hearing peers.
Objectives:
There is growing evidence that early application of a cochlear implant in children affected by profound congenital hearing loss is of paramount importance for the development of an adequate auditory performance and language skills. For these reasons and as a result of advances in audiologic diagnosis and an enhanced awareness of the safety of cochlear implants, the age of implantation has substantially decreased over recent years. Children aged as little as 12 months are now being implanted in some centers. On the basis of our experience with very young children, we believe that the date of implantation may be further reduced to only 4 to 6 months of age.
Study Design:
Over the period from November 1998 to April 2004, 103 children have been fitted with cochlear implants and 11 with auditory brainstem implants in our department, including 65 children aged below 3 years. The present study focuses on 10 children aged less than 12 months fitted with cochlear implants from November 1998 to December 2003.
Methods:
The children's ages ranged from 4 to 11 (mean 9.5) months. Five were males and five females. All received a Nucleus CI 24 M. Postoperative auditory performance, as evaluated at the latest follow-up, was based on the category of auditory performance (CAP). The results obtained in these 10 children were compared with those obtained with cochlear implants in children belonging to older age brackets. The criteria used to assess speech performance were onset of babbling onset and babbling spurt, and the results observed were compared with those of a control group of 10 normally hearing children.
Results:
Surgery was uneventful, and no immediate or delayed complications were encountered. Auditory performance was seen to increase as function of early age of implantation and length of implant use. All 10 children had a CAP score of 3 within 6 months of cochlear implant activation. The onset of babbling occurred very early (i.e., within 1 to 3 months of activation of the implant in all 10 patients), regardless of age at implantation, whereas the babbling spurt was recorded at times ranging from 3 to 5 months after implant activation. The positive impact of early implantation on babbling was clearly shown by the fact that the earlier the activation of the cochlear implant, the closer the results were to the outcomes of normally hearing children.
Conclusions:
We encourage very early implantation to facilitate a series of developmental processes occurring in the critical period of initial language acquisition. The indices we used in the present study (i.e., CAP and babbling) suggest that early cochlear implantation tends to yield normalization of audio-phonologic parameters, which enables us to consider the performance of children implanted very early as being similar to that of their normally hearing peers.
