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Updated: Jun 11, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear implantations in young children with cochlear nerve deficiency diagnosed by MRI
Woo Seok Kang1, Jeong Hyun Lee, Ha Na Lee
1Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Insights
Cochlear implantation outcomes are significantly worse in young children with cochlear nerve deficiency compared to those with normal cochlear nerves. Magnetic resonance imaging (MRI) identification of cochlear nerve deficiency indicates a poor prognosis for cochlear implant success.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Cochlear implantation is a common treatment for severe to profound hearing loss in children.
- Cochlear nerve deficiency, identified via magnetic resonance imaging (MRI), may impact surgical outcomes.
- Assessing the impact of cochlear nerve deficiency on auditory development is crucial for patient management.
Purpose of the Study:
- To compare postoperative outcomes of cochlear implantation in young children with cochlear nerve deficiency versus those with normal cochlear nerves.
- To evaluate the predictive value of cochlear nerve deficiency on magnetic resonance imaging (MRI) for cochlear implant success.
Main Methods:
- A historical cohort study was conducted at a tertiary referral center.
- Six children under 36 months with cochlear nerve deficiency (diagnosed by MRI) and 15 age-matched children with normal cochlear nerves underwent cochlear implantation.
- Data were collected through review of medical records, imaging studies, and speech evaluations.
Main Results:
- Children with cochlear nerve deficiency scored lower on the Infant-Toddler Meaningful Auditory Integration Scale.
- Speech intelligibility scores remained at zero for the cochlear nerve deficiency group at 12 months post-implantation, unlike the control group.
- Five of six children with cochlear nerve deficiency showed no response in open-set syllable tests, with one showing delayed improvement after 18 months.
Conclusions:
- Nonvisualized cochlear nerves on MRI in young children are associated with significantly worse cochlear implantation outcomes.
- Cochlear nerve deficiency identified by MRI serves as a strong indicator of very poor outcomes following cochlear implantation.
Objective:
To investigate postoperative outcomes after cochlear implantation in young children with cochlear nerve deficiency and compare the results with those of cochlear implantation in patients with normal cochlear nerve.
Study Design:
Historical cohort study.
Setting:
Tertiary referral center.
Subjects And Methods:
Six children under the age of 36 months with cochlear nerve deficiency, as determined by magnetic resonance imaging (MRI), received cochlear implantation between July 2006 and March 2008. Fifteen children under the age of 36 months with normal cochlear nerve in the implanted ear underwent cochlear implantation during the same period and were selected as the control group. Medical records, imaging studies, and speech evaluations were reviewed.
Results:
Our study group scored lower in the Infant-Toddler Meaningful Auditory Integration Scale compared to the control group. Our study group produced categories of auditory performance scores not less than 4 except for one patient. Speech intelligibility rating scores in the control group gradually increased after cochlear implantation, but for the study group, the score remained zero 12 months after the implantation. In open-set one-syllable tests, five patients with cochlear nerve deficiency showed no response at the latest follow-up, whereas patient 6 began to show delayed improvement after 18 months. The results of the open-set two-syllable test were similar to those of the open-set one-syllable test.
Conclusion:
Young children with nonvisualized cochlear nerve on MRI showed worse outcomes compared to the children with normal cochlear nerve. Cochlear nerve deficiency on MRI is a marker of very poor outcome with cochlear implantations.