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Updated: Apr 15, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Is very early hearing assessment always reliable in selecting patients for cochlear implants? A case series study
R Bovo1, P Trevisi1, S Ghiselli1
1ENT Clinic, Padova University Hospital, Italy.
Insights
Many infants with severe-to-profound hearing loss show significant improvement with early intervention and regular audiological testing. This case series highlights the potential for auditory threshold recovery within the first year of life.
Area of Science:
- Pediatric audiology
- Neonatal hearing screening
- Auditory development
Background:
- A case series of 23 infants diagnosed with severe-to-profound hearing loss at 3 months old was studied.
- These infants demonstrated significant auditory threshold improvement within their first year of life, with some reaching normal levels.
Purpose of the Study:
- To analyze the auditory development in infants with severe-to-profound hearing loss.
- To determine the optimal follow-up and intervention timelines for different infant populations.
Main Methods:
- Infants received audiological follow-up every 2 months post-hearing aid fitting.
- A range of audiological tests including DPOAE, ABR, behavioral responses, CAEP, and ECoG were employed.
- Consistency between test findings was assessed during follow-up.
Main Results:
- The study cohort included infants with prematurity, malformations, congenital CMV, hyperbilirubinemia, hypoxia, and sepsis.
- Term-born infants showed improvement by 6 months; preterm infants showed improvement beyond 70 weeks gestational age.
- One preterm infant showed threshold amelioration beyond 85 weeks gestational age.
Conclusions:
- Cochlear implantation (CI) should be considered only after a period of auditory stimulation and comprehensive testing.
- CI is recommended after 8 months for term-born infants with persistent hearing loss.
- Severely preterm infants require extended follow-up up to at least 80 weeks gestational age before considering CI.
Introduction:
This study concerns a case series of 23 infants with a diagnosis of severe-to-profound hearing loss at 3 months old, who significantly improved (even reaching a normal auditory threshold) within their first year of life.
Methods:
All infants were routinely followed up with audiological tests every 2 months after being fitted with hearing aids as necessary. A reliable consistency between the various test findings (DPOAE, ABR, behavioral responses, CAEP and ECoG) clearly emerged in most cases during the follow-up, albeit at different times after birth.
Results:
The series of infants included 7 cases of severe prematurity, 6 of cerebral or complex syndromic malformations, 5 healthy infants, 2 with asymptomatic congenital CMV infection, and 1 case each of hyperbilirubinemia, hypoxia, and sepsis. All term-born infants showed a significant improvement over their initial hearing threshold by 6 months of age, while in most of those born prematurely the first signs of threshold amelioration occurred beyond 70 weeks of gestational age, and even beyond 85 weeks in one case.
Conclusions:
Cochlear implantation (CI) should only be considered after a period of auditory stimulation and follow-up with electrophysiological and behavioral tests, and an accurate analysis of their correlation. In our opinion, CI can be performed after a period of 8 months in all term-born infants with persistent severe-to-profound hearing loss without risk of diagnostic error, whereas the follow-up for severely preterm infants should extend to at least 80 weeks of gestational age.
