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Updated: Oct 8, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta-analysis
Firas Sbeih1, Malek H Bouzaher1, Swathi Appachi1
1Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Insights
Cochlear implantation in infants 12 months and younger shows a low rate of complications, comparable to older children. This systematic review confirms the safety of early cochlear implantation for pediatric hearing loss.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Cochlear implantation is a critical intervention for pediatric hearing loss.
- Determining the safety profile in very young infants (≤12 months) is essential for clinical decision-making.
Approach:
- A systematic review and meta-analysis of studies published up to March 20, 2021.
- Inclusion criteria focused on pediatric patients ≤12 months with reported intraoperative or postoperative complications.
- Data extraction included complications, explants, readmissions, and hospitalizations, with rigorous quality and bias assessment.
Key Points:
- 18 studies involving 449 patients and 625 cochlear implants were analyzed.
- Major complication rates were 3.1% in patients and 2.3% in implantations.
- Minor complication rates were 2.4% in patients and 1.8% in implantations; no anesthetic complications were reported.
Conclusions:
- Cochlear implantation in infants ≤12 months demonstrates a favorable safety profile.
- Complication rates in this young cohort are comparable to those observed in older pediatric populations.
- Early cochlear implantation is a safe and effective option for managing hearing loss in very young children.
Objective:
To systematically review the literature to determine safety of cochlear implantation in pediatric patients 12 months and younger.
Data Source:
Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to March 20, 2021.
Review Methods:
Studies that involved patients 12 months and younger with report of intraoperative or postoperative complication outcomes were included. Studies selected were reviewed for complications, explants, readmissions, and prolonged hospitalizations. Two independent reviewers screened all studies that were selected for the systematic review and meta-analysis. All studies included were assessed for quality and risk of bias.
Results:
The literature search yielded 269 studies, of which 53 studies underwent full-text screening, and 18 studies were selected for the systematic review and meta-analysis. A total of 449 patients and 625 cochlear implants were assessed. Across all included studies, major complications were noted in 3.1% of patients (95% CI, 0.8-7.1) and 2.3% of cochlear implantations (95% CI, 0.6-5.2), whereas minor complications were noted in 2.4% of patients (95% CI, 0.4-6.0) and 1.8% of cochlear implantations (95% CI, 0.4-4.3). There were no anesthetic complications reported across all included studies.
Conclusion:
The results of this systematic review and meta-analysis suggest that cochlear implantation in patients 12 months and younger is safe with similar rates of complications to older cohorts.
