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Updated: May 31, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Prognostic indicators in paediatric cochlear implant surgery: a systematic literature review
Jane Black1, Louise Hickson, Bruce Black
1School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Brisbane, Australia. jbblack@bigpond.com
Insights
Identifying prognostic factors for pediatric cochlear implantation (PCI) is crucial. This review found limited evidence, highlighting only four key factors: age at implantation, Connexin 26, inner ear malformations, and meningitis, to improve PCI outcomes.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Pediatric cochlear implantation (PCI) involves complex evaluation, surgery, and habilitation.
- Outcomes can be suboptimal due to various adverse influences.
Purpose of the Study:
- Systematically review literature for prognostic factors in pediatric CI.
- Aim to develop a clinical prognostic index for PCI.
Main Methods:
- Assessed six domains: medical/surgical, audiology, psychology, speech/language, education, and family.
- Applied systematic search strategies and strict inclusion criteria.
- Used a critical appraisal tool for eligible citations.
Main Results:
- Identified 92 citations; 38 were eligible.
- Study heterogeneity prevented quantitative meta-analysis.
- Four factors consistently influenced PCI outcomes: age at implantation, Connexin 26, inner ear malformations, and meningitis.
Conclusions:
- Adverse prognostic factors in pediatric CI are underreported.
- Improved identification of these factors is needed for better pre-operative counseling and surgical expectations.
Background:
Paediatric cochlear implantation (PCI) requires complex case evaluation and counselling, surgical intervention, and habilitation. Outcomes vary and many cases have sub-optimal outcomes as a result of a broad spectrum of adverse influences.
Objective:
To systematically review the literature to identify research papers that indicate a demonstrated outcome or prognostic factor in paediatric CI, the overall aim being to develop a prognostic index for clinical use.
Methods:
Six main literature domains were assessed: medical/surgical; audiology; psychology; speech/language; education; and family. Search strategies were applied to appropriate databases and journals. A strict inclusion criterion was utilized. A critical appraisal tool was administered to evaluate the final eligible citations.
Results:
The review identified 92 citations, of which 38 were eligible. Heterogeneity in study design prevented a quantitative meta-analysis of the data. Discussion While there are a large range of factors that impact PCI outcomes, well-constructed case control studies are limited in number and scope and relatively few demonstrated significant prognostic factors. Only four factors were identified as consistently influencing PCI outcomes: age at implantation, Connexin 26, inner ear malformations, and meningitis.
Conclusion:
Evaluation of relevant adverse prognostic factors in paediatric CI remains a largely unreported field. Better identification of these factors is required for improving vital pre-operative counselling and resultant surgical expectations and outcomes.