Analysis of paediatric cochlear implant candidacy: Single centre, retrospective observational study

The criteria for cochlear implantation can differ among countries or even among regions in the same country. Patient selection is important for the identification of those children who can benefit the most from cochlear implants. A number of patients who are possible cochlear implant candidates do not meet the assessment criteria; and some of these requirements are modifiable components.

This single-centre, cross-sectional study used secondary data from 2014 until 2018. A consecutive sampling method was applied and a final sample size of 73 samples was achieved. Potential prelingual hearing loss candidates for cochlear implant aged less than 48 months old in Raja Permaisuri Bainun Hospital (HRPB), Ipoh Perak were included in this study. The candidacy selection outcome was analysed and reported as proportions. The associations between the evaluation criteria and outcome were examined using regression analysis.

Of the 73 potential candidates, only 17 (23%) were selected to receive cochlear implants. Bivariate analysis identified hearing compliance, behaviour, medical contraindications and family commitment as significantly associated with cochlear implant evaluation outcome. However, multivariate logistic regression revealed only family commitment as a significant predictor of the outcome of the implant candidacy evaluation (OR 44.7; 95%CI 3.11-643.4; p<0.005).

Family commitment, a modifiable element, was the key factor affecting the selection of candidates. Addressing the reasons for this effect could increase the number of potential candidates who ultimately receive implants.