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Published on: January 25, 2016
Pediatric Bilateral Sensorineural Hearing Loss: Minimum Test Battery and Referral Criteria for Cochlear Implant
Samantha Anne1, Kevin D Brown2, Donald M Goldberg1,3
1Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Insights
Cochlear implants are FDA-approved for children with severe to profound hearing loss who show limited progress with hearing aids. Early implantation is crucial for speech and language development in young children.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Speech-Language Pathology
Background:
- Current Food and Drug Administration (FDA) labeling specifies criteria for pediatric cochlear implant (CI) use.
- Pediatric CI candidacy requires profound bilateral sensorineural hearing loss (SNHL) in infants 9-24 months, and severe to profound SNHL in children over 2 years.
- A 3-month hearing aid trial is typically mandated, with exceptions for ossification evidence.
Purpose of the Study:
- To outline the current FDA-approved criteria for pediatric cochlear implantation.
- To emphasize the importance of timely intervention for optimal speech and language development.
- To highlight the developmental window critical for auditory processing.
Main Methods:
- Review of current Food and Drug Administration (FDA) approved labeling for pediatric cochlear implant systems.
- Analysis of pediatric guidelines regarding speech understanding thresholds for CI candidacy.
- Consideration of the critical period for speech and language acquisition.
Main Results:
- Pediatric cochlear implantation is indicated for specific degrees of bilateral sensorineural hearing loss.
- Eligibility requires documented limited progress in auditory, speech, and language development despite hearing aid use.
- Children must demonstrate significantly poorer speech understanding to qualify for cochlear implantation.
Conclusions:
- Early cochlear implantation is vital for children experiencing significant hearing loss.
- Auditory deprivation during early childhood can severely impact speech and language development.
- Adherence to established guidelines ensures appropriate candidacy for pediatric cochlear implants.
Abstract:
Among the various cochlear implant systems approved by the Food and Drug Administration, current labeling for pediatric usage encompasses (1) bilateral profound bilateral sensorineural hearing loss in children aged 9 to 24 months and bilateral severe to profound sensorineural hearing loss in children older than 2 years; (2) use of appropriately fitted hearing aids for 3 months (this can be waived if there is evidence of ossification); and (3) demonstration of limited progress with auditory, speech, and language development. Pediatric guidelines require children to have significantly worse speech understanding before qualifying for cochlear implantation. The early years of life have been shown to be critical for speech and language development, and auditory deprivation is especially detrimental during this crucial time.Level of evidence: 2.
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