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Updated: Dec 10, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
The French Cochlear Implant Registry (EPIIC): Perception and language results in infants with cochlear implantation
N Loundon1, F Simon1, K Aubry2
1Department of Pediatric Otolaryngology, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
Insights
Cochlear implants (CIs) significantly improve auditory perception and language skills in profoundly deaf infants. Early implantation, whether unilateral or bilateral, leads to better speech intelligibility and mainstream schooling integration.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Neuroscience
Background:
- Infantile deafness poses significant challenges to auditory development and communication.
- Cochlear implantation (CI) is a critical intervention for profound hearing loss in infants.
- The National French Registry (EPIIC) provides valuable data on pediatric CI outcomes.
Purpose of the Study:
- To evaluate the outcomes of cochlear implantation in infants under 24 months.
- To compare the effectiveness of unilateral versus bilateral cochlear implantation.
- To analyze audiological, speech, and educational results from a national registry.
Main Methods:
- A multi-center study included 615 infants receiving cochlear implants (CIs) before age two.
- Data collected included implantation type, complications, cause of deafness, and follow-up at 12, 24, 36, and 48 months.
- Key metrics: Category of Auditory Perception (CAP), Open-set Word Recognition (OSW), speech intelligibility, and schooling type.
Main Results:
- Mean implantation age was 16 months; 52% received unilateral CI, 56% of bilateral were sequential.
- Genetic causes and cytomegalovirus (CMV) were significant factors in deafness etiology.
- Four years post-op, high rates of auditory perception (CAP≥5: 84% UniCI, 75% BiCI) and word recognition (OSW≥80%: 83% UniCI, 100% BiCI) were observed.
Conclusions:
- The EPIIC registry offers unique insights into pediatric CI outcomes.
- Both unilateral and bilateral cochlear implantation demonstrate immediate benefits for auditory skills and language development.
- Early CI intervention positively impacts communication mode and educational integration in children with profound hearing loss.
Objective:
Multi-centre study of the National French Registry (EPIIC) of patients with cochlear implants, focusing on infants who were operated-on under the age of 24 months between 2012 and 2016.
Patients And Methods:
A total of 615 profoundly deaf infants, who received cochlear implants (CIs) before their second birthday, were included in the registry by different CI centers. Epidemiological, surgical, speech therapy and school, follow-up data were included in the registry, 12, 24, 36 and 48 months thereafter. The following parameters were studied: type of implantation (uni- or bilateral), complications, cause of deafness, category of auditory perception (CAP), Open-set word recognition score (OSW), speech intelligibility rating, lexical comprehension with EVIP (Peabody), communication mode and type of schooling. Bilateral simultaneous CI (BiCI) and unilateral CI (UniCI) groups were compared.
Results:
There were 744 implantations. The explantation-reimplantation rate, within the four-year follow-up, was just 3.6%. Mean implantation age was 16.0 months, and similar in the two groups (BiCI/UniCI). A total of 51% of children had their first implant between 12 and 18 months, and 15% before 12 months. Implantation was unilateral in 52% of cases. Fifty-six percent of the bilateral procedures were sequential, with a mean delay of 16.8 months for the second implantation. The cause of deafness was unknown in 52% of cases. Of the 48% (297/615) of attributed cases, 32% had clear genetic causes. The remaining deafness was due to cytomegalovirus (CMV, 8%), inner-ear malformation (5%) and meningitis (3%). The main complications were from infections (47%) and internal device failure (25%). Four years post-operation, 84% of the UniCI and 75% of BiCl groups had a CAP≥5, and 83% of UniCl and 100% BiCI had OSW≥80%. Furthermore 74% of UniCI and 77% of BiCI communicated orally and 85% of UniCI and 90% of BiCI integrated into mainstream schooling.
Conclusion:
The French Registry of cochlear implants (EPIIC) is the only such national registry in the world. Our analysis illustrates the immediate benefits of, either single or double, cochlear implantation for language, perception skills and schooling.
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