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Updated: Dec 26, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Effects of Age at Cochlear Implantation on Auditory Outcomes in Cochlear Implant Recipient Children
Vishal Gaurav1, Shalabh Sharma1, Satinder Singh1
1Sir Ganga Ram Hospital, New Delhi, 110060 India.
Insights
Early cochlear implantation (CI) significantly improves auditory outcomes in children with hearing loss. Even later CI provides substantial benefits, aiding in outcome prediction and family counseling.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Speech-Language Pathology
Background:
- Bilateral severe to profound sensorineural hearing loss impacts children's development.
- Technological advancements enable earlier cochlear implantation (CI) for infants and toddlers.
- Understanding the impact of implantation age is crucial for optimizing CI outcomes.
Purpose of the Study:
- To investigate the effect of age at cochlear implantation (CI) on auditory perception outcomes.
- To compare outcomes between children implanted at ≤5 years versus >5 years of age.
- To provide data for predicting CI success and counseling families.
Main Methods:
- Prospective study of 50 children undergoing cochlear implantation (CI).
- Group 1: 15 children implanted at >5 years of age (case).
- Group 2: 35 children implanted at ≤5 years of age (control).
- Auditory perception assessed 1 year post-CI using Categories of Auditory Performance (CAP) and Meaningful Auditory Integration Scale (MAIS).
Main Results:
- Children implanted at ≤5 years showed significantly better auditory outcomes (12.29% increase in CAP, 14.05% in MAIS) compared to those implanted later.
- Children implanted after 5 years still achieved >80% of maximum CAP and MAIS scores.
- Substantial auditory perception improvement was observed in all children, regardless of implantation age.
Conclusions:
- Cochlear implantation (CI) at ≤5 years of age leads to significantly better 1-year auditory outcomes.
- Early CI is preferable for optimal auditory rehabilitation in children.
- CI remains beneficial for children implanted after 5 years, with age at implantation aiding outcome prediction and family counseling.
Abstract:
Cochlear implantation (CI) is used for rehabilitation of children with bilateral severe to profound sensorineural hearing loss. Recently, treatment of such children has been influenced by diagnostic technological advances. Infants and toddlers are now increasingly included for CI. The primary aim of this study was to determine the effects of 'age at CI' on CI outcome. The primary aim of this study was to determine the effects of 'age at CI' on CI outcome. In this prospective study at a tertiary care centre, we evaluated 50 cochlear implanted children from October 2011 to March 2013. The case group consists of 15 (30%) children who underwent CI at more than 5 years of age and control group consisted of 35 (70%) children who underwent CI at less than or equal to 5 years age. All patients received auditory and speech rehabilitation and we evaluated their auditory perception outcomes 1 year post CI, the children were assessed by categories of auditory performance (CAP) and meaningful auditory integration scale (MAIS) tests. There were significantly improved mean auditory perception outcomes (increase of 12.29% in CAP, and 14.05% in MAIS scores) at 1 year post CI in CI recipients of age group '5 years or less' in comparison to those who underwent CI at 'more than 5 years of age'. However, children of 'more than 5 years' age at CI, mean CAP and MAIS scores were still more than 80% of maximum achievable CAP and MAIS scores. In this study, CI recipient children who were implanted at less than or equal to 5 years of age were found to have significantly improved auditory perception outcome at 1 year post CI. Hence, it appears preferable to provide CI early. However, even in children who underwent CI at more than 5 years of age, there was substantial improvement in auditory perception outcomes and CI was still helpful in these children. Hence, knowledge of 'age at CI' can provide reasonable help in predicting the auditory perception outcome and optimal counselling of families of CI candidates.
