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A Ten-Year Review of Audiological Performance in Children with Inner Ear Abnormalities after Cochlear Implantation in
Sok Yan Tay1, Rosslyn Anicete2, Kun Kiaang Henry Tan2
1Department of Otolaryngology, Head and Neck Surgery, National University Hospital System (NUHS), Singapore.
Insights
Children with inner ear malformations undergoing cochlear implantation (CI) showed varied outcomes. Absent cochlear nerve, electrode folding, and neurological disorders were linked to poorer results in pediatric CI patients.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Medical Imaging
Background:
- Inner ear malformations (IEM) present unique challenges for cochlear implantation (CI) in children.
- Understanding factors influencing CI outcomes in this population is crucial for improving auditory rehabilitation.
Purpose of the Study:
- To evaluate outcomes of cochlear implantation in children with inner ear malformations.
- To identify factors associated with successful CI outcomes in pediatric patients with IEM.
Main Methods:
- Retrospective cohort study of 70 children (aged 0-18 years) who underwent CI between 2000 and 2013.
- Analysis of demographic data, risk factors, IEM type, age at implantation, pre- and post-implantation speech, and audiological outcomes.
- Review of operative details and CT scan findings, including cerebrospinal fluid (CSF) gusher incidence.
Main Results:
- Eighty-three CI surgeries were performed; 28.57% had abnormal CT findings.
- CSF gusher occurred in 57.69% of IEM cases. Pre-implantation IT-MAIS scores averaged 14.1 for anomalous inner ears.
- 55% achieved good speech and hearing for mainstream school reintegration; 20% showed poor progress.
Conclusions:
- Absent cochlear nerve, electrode folding, and neurological disorders were associated with poorer CI outcomes.
- Early identification and management of these factors may improve CI success rates in children with IEM.
Objectives:
To evaluate children with inner ear malformations following cochlear implantation (CI) in a tertiary pediatric hospital in Singapore to identify factors influencing outcomes after CI.
Methods:
This is a retrospective cohort study of children aged 0 to 18 years, who had CI between 2000 and 2013. Demographic information, data on risk factors, type of inner ear malformation (IEM), age at implantation, speech pre- and postimplantation, and duration of follow-up were collected from clinical records. Operative details and audiological outcomes were also analyzed.
Results:
A total of 70 children underwent 83 CI surgeries. The mean age of the patients was 4.05 ± 3.17 years (range 1-18 years). Twenty patients (28.57%) had abnormal CT scan findings. CSF gusher occurred in 15 out of 26 CI (57.69%) in the group with IEM. Nine out of twenty patients (45.00%) had poor IT-MAIS scores prior to implantation. The average preoperative IT-MAIS score for children with anomalous inner ear anatomy was 14.1. The older CI patients, 3/20 (15.00%), mean age 8.33 years (range 7-10 years), were mostly referred for persistently unclear speech following hearing aids. Eleven patients (55.00%) had good speech and aided hearing threshold within speech limits after CI and were eligible for reintegration into mainstream schools. Five patients (25.00%) had improvement in speech but continued to receive education in special schools. Four patients (20.00%) had poor progress after surgery.
Conclusion:
The presence of absent cochlear nerve, electrode folding, and underlying neurological disorders seemed to be associated with poorer outcomes.
