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Updated: Jun 5, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
[Feasibility analysis and surgical highlight of cochlear implantation in infants under 12 months of age]
Zhi-hua Zhang1, Qi Huang, Zhao-yan Wang
1Department of Otolaryngology Head and Neck Surgery, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
Insights
Cochlear implantation is feasible in infants under 12 months, offering improved auditory and language outcomes. Early intervention for profound sensorineural hearing loss is safe and effective, with fewer complications in younger children.
Area of Science:
- Otolaryngology
- Pediatric audiology
- Neurosurgery
Context:
- Bilateral profound sensorineural hearing loss in infants requires timely intervention.
- Cochlear implantation is a viable treatment option for hearing loss.
- Early surgical intervention aims to mitigate developmental delays.
Purpose:
- To assess the feasibility and surgical outcomes of cochlear implantation in infants under 12 months.
- To compare surgical parameters and auditory development in infants <12 months versus 13-24 months.
- To identify key surgical factors for successful cochlear implantation in young infants.
Summary:
- Cochlear implantation in infants under 12 months showed comparable operative duration and bleeding to older children, with a shorter hospital stay and fewer complications.
- Auditory and language development in the younger group improved significantly, with no difference compared to the older group.
- Early cochlear implantation effectively reduced auditory deprivation, with 80% achieving a high Category of Auditory Performance (CAP) score.
Impact:
- Demonstrates the safety and efficacy of early cochlear implantation in infants.
- Highlights the benefits of reduced auditory deprivation for long-term language development.
- Suggests experienced otologists should cautiously undertake this procedure in very young infants.
Objective:
To explore feasibility and surgical highlight of cochlear implantation in infants under 12 months of age.
Methods:
A retrospective review was performed in 14 infants under 12 months of age and 63 cases from 13 to 24 months of age with bilateral profound sensorineural hearing loss, who underwent unilateral cochlear implantation surgery. The operative parameters, including operation duration, amount of intraoperative bleeding, length of hospital stay, surgical complications and auditory outcomes, including warble tone average aided in free field, category of auditory performance (CAP), language behavior development quotient, babbling onset or spurt were recorded.
Results:
There was no significant difference between infants younger than 12 months and older in operation duration, amount of intraoperative bleeding, except for the length of hospital stay. Otherwise, less complication occurred in younger group (7.1% and 11.1%, respectively, χ(2) = 0.19, P > 0.05). The surgical highlights and experience, strictly restricted operation duration, intimate cooperation among the treatment team members and reduction of intraoperative bleeding are key points to ensure safety and success of the operation. The warble tone average aided in free field and language behavior developmental quotient of younger infants were both improved during follow-up and showed no significant difference compared with older group (t = 4.6 and 3.8, P > 0.05). 80% of infants who finished 24 months follow-up had a CAP score of 6 or 7. The babbling onset in younger group occurred at (14.1 ± 0.9) months of life, which was better than that in older group [(22.6 ± 3.0) months of life].
Conclusions:
It is feasible to put cochlear implantation in infants under 12 months of age. And the earlier cochlear implantation could shorten auditory deprivation for children with bilateral congenital profound sensorineural hearing loss. Considering the high requirement of surgical highlights and experience, the suggest was that only experienced otologists challenge this domain cautiously.