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Updated: May 13, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear implantation in children 12 months of age and younger
Michelle A Holman1, Matthew L Carlson, Colin L W Driscoll
1Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
Insights
Cochlear implantation (CI) in infants under 12 months is safe and effective, leading to age-appropriate speech and language skills. Surgical and anesthetic risks are comparable to older children and adults.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Developmental Pediatrics
Background:
- Early identification of severe-to-profound sensorineural hearing loss (SNHL) is crucial for optimal child development.
- Cochlear implantation (CI) is a viable treatment option for infants with SNHL.
- Investigating outcomes in very young CI recipients is essential for refining surgical protocols and understanding developmental trajectories.
Purpose of the Study:
- To evaluate surgical, anesthetic, and device-related complications in children receiving cochlear implants (CI) at 12 months or younger.
- To assess auditory and speech-language development outcomes in this cohort.
- To compare outcomes with a control group of children implanted between 13 and 24 months of age.
Main Methods:
- Retrospective chart review at a tertiary academic referral center.
- Inclusion of children with severe-to-profound SNHL who underwent CI at ≤12 months.
- Comparison with an audiometric control group implanted between 13-24 months.
Main Results:
- No major surgical or anesthetic complications were observed in the infant CI group.
- Low rates of device-related issues (4% device failure, 8% electrode anomalies).
- 73% of infants achieved age-appropriate speech and language skills by 24 months, significantly earlier than the control group (40 months).
Conclusions:
- Cochlear implantation offers significant benefits for infant recipients.
- Surgical and anesthetic risks are similar to older pediatric and adult patients when performed by experienced teams.
- Early CI in infants facilitates timely acquisition of critical auditory and language milestones.
Objective:
To investigate surgical, anesthetic, and device-related complications as well as auditory and speech-language development outcomes associated with cochlear implantation (CI) in children 12 months of age and younger.
Study Design:
Retrospective chart review.
Setting:
Tertiary academic referral center.
Patients:
All children with severe-to-profound sensorineural hearing loss who underwent cochlear implantation at 12 months of age or younger and an audiometric control group implanted between 13 and 24 months of age.
Main Outcome Measures:
Anesthetic and surgical course; major and minor surgical, anesthetic and device-related complications; postoperative disposition; postoperative auditory receptive and expressive language development.
Results:
Twenty-six patients (41 ears) met criteria. The median duration of follow-up was 58 months. No major surgical or anesthetic complications occurred. One patient (4%) experienced device failure, which required revision surgery and implant exchange. Two other patients (8%) had individual electrode anomalies that were treated with map exclusion. At the last recorded follow-up, 73% of patients were performing at or above the level of normal-hearing age-matched peers. Patients that were implanted at 12 months of age or younger reached age-appropriate speech and language skills by 24 months of age compared with 40 months for the older pediatric control group.
Conclusion:
The current study demonstrates that CI provides substantial benefit among infant recipients. Furthermore, when performed by an experienced cochlear implant and pediatric anesthesia team, the surgical and anesthetic risks are similar to that expected with both older pediatric and adult patients.