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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Hearing preservation cochlear implantation in children: The HEARRING Group consensus and practice guide
Gunesh Rajan1, Dayse Tavora-Vieira1, Wolf-Dieter Baumgartner2
1a Department of Otolaryngology, Head and Neck Surgery , School of Surgery, University of Western Australia , Murdoch , Australia.
Insights
Hearing preservation cochlear implantation (HPCI) is a safe and effective option for children, even with partial deafness (PD). Early detection and multidisciplinary assessment are crucial for successful HPCI outcomes.
Area of Science:
- Otolaryngology
- Audiology
- Pediatric Medicine
Background:
- Current evidence and practice regarding pediatric cochlear implantation, focusing on hearing preservation.
- The need for updated guidelines for multidisciplinary teams performing hearing preservation cochlear implantation (HPCI).
- Addressing the specific challenges of HPCI in children with symptomatic partial deafness (PD) for electric-acoustic stimulation (EAS).
Framework:
- Consensus statement developed by the HEARRING group.
- Review of current evidence and clinical practices for HPCI in children.
- Focus on three key questions: candidacy, assessment, and management.
Implementation:
- Guidelines for identifying suitable candidates for HPCI.
- Protocols for comprehensive pre-implantation assessment in children.
- Recommendations for surgical timing, particularly with Med-El Flex electrode arrays.
Implications:
- HPCI is a safe and reliable treatment for all children undergoing cochlear implantation, regardless of residual hearing.
- Early detection and multidisciplinary assessment are vital for identifying pediatric candidates for HPCI.
- Timely HPCI intervention is recommended for children with symptomatic PD to maximize benefits.
Objectives:
To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines on who is a candidate, how to assess these children and when to implant if Med-El Flex electrode arrays are chosen for implantation.
Methods:
The HEARRING group reviewed the current evidence and practice regarding the management of children to be considered for HPCI surgery emphasizing the assessment needed prior to implantation in order to demonstrate the benefits in these children over time. The consensus statement addresses following three key questions: (1) Should these children be treated? (2) How to identify these children? (3) How to manage these children?
Summary:
The HEARRING group concludes that irrespective of the degree of residual hearing present, the concepts of hearing and structure preservation should be applied in every child undergoing cochlear implantation and that HPCI is a safe and reliable treatment option. Early detection and multidisciplinary assessment are key to the identification of children with symptomatic PD, these children should undergo HPCI as early as possible.
