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Updated: Jan 1, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Impact of cochlear abnormalities on hearing outcomes for children with cochlear implants
Evette Ronner1, Razan Basonbul2, Rupal Bhakta1
1Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, United States of America.
Insights
Cochlear anomalies negatively impact hearing outcomes in pediatric cochlear implant patients. Abnormalities significantly worsened pure tone averages compared to normal anatomy, highlighting the need for further research.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Medical Imaging
Background:
- Cochlear implants are vital for pediatric hearing restoration.
- Radiological assessment of cochlear anatomy is crucial before implantation.
- The impact of cochlear anomalies on hearing outcomes requires further elucidation.
Purpose of the Study:
- To evaluate how cochlear anomalies affect hearing results in pediatric cochlear implant recipients.
- To compare hearing outcomes between children with and without cochlear abnormalities.
Main Methods:
- Retrospective chart review of pediatric cochlear implant surgeries (2002-2018).
- Classification of cochlear abnormalities as low or high risk.
- Assessment of hearing outcomes using pure tone averages and word recognition scores pre- and post-operatively.
Main Results:
- Inner ear anomalies were present in 47 of 100 pediatric patients.
- Patients with cochlear anomalies had significantly higher postoperative pure tone averages than those with normal anatomy.
- No significant difference in pure tone averages was found between low and high-risk anomaly groups.
Conclusions:
- Cochlear abnormalities significantly influence long-term hearing outcomes after cochlear implantation in children.
- Challenges in obtaining consistent hearing test data in young children necessitate further investigation.
- Understanding the effect of cochlear anomalies is critical for optimizing cochlear implant outcomes.
Objective:
Evaluate the impact of cochlear anomalies on hearing outcomes for pediatric patients with cochlear implants.
Study Design:
Retrospective chart review.
Setting:
Tertiary care center.
Subjects And Methods:
Charts were retrospectively reviewed for cases where pediatric cochlear implant surgery was performed between 2002 and 2018 at a single, tertiary care institution. Patients were divided into groups based on the presence or absence of radiological cochlear abnormalities, which were further classified as low or high risk anomalies. Hearing outcomes were evaluated by measuring pure tone averages and word recognition scores preoperatively, 3 and 12 months postoperatively, in addition to the most recent test results.
Results:
There were 154 ears implanted in our cohort of 100 patients. 107 ears had normal cochlear anatomy, 31 had low risk, and 16 had high risk abnormalities. The most common modality of preoperative imaging was CT scan. Postoperative mean pure tone average (PTA) was significantly higher in patients with inner ear anomalies compared to those with normal anatomy. No significant difference in PTA was noted between low versus high risk patients. <50% of patients had word recognition scores available within the first year following surgery.
Conclusion:
Abnormalities of the inner ear significantly influenced hearing outcomes over time following cochlear implant surgery when compared to pediatric patients with normal anatomy. Obtaining hearing testing can be difficult in very young children and therefore future studies are warranted to further investigate the impact that cochlear abnormalities may have on hearing outcomes following cochlear implant surgery.
