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Updated: Sep 29, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Analysis of paediatric cochlear implant candidacy: Single centre, retrospective observational study
1Raja Permaisuri Bainun Hospital, Clinical Research Centre (CRC) department, Ipoh Perak, Malaysia. limxj.crc@gmail.com.
Insights
Family commitment is the key factor for cochlear implant candidacy in young children. Addressing this modifiable element could increase the number of children receiving cochlear implants.
Area of Science:
- Audiology and Otolaryngology
- Pediatric Health
- Medical Device Technology
Background:
- Cochlear implant candidacy criteria vary globally, impacting patient selection for children with hearing loss.
- Identifying suitable candidates is crucial for maximizing the benefits of cochlear implantation.
- Some existing assessment criteria for cochlear implants are modifiable.
Purpose of the Study:
- To analyze cochlear implant candidacy selection outcomes in prelingual hearing loss patients under 48 months.
- To identify factors influencing cochlear implant evaluation outcomes.
- To determine the significance of family commitment in pediatric cochlear implant candidacy.
Main Methods:
- Single-center, cross-sectional study utilizing secondary data from 2014-2018.
- Consecutive sampling of 73 potential pediatric cochlear implant candidates.
- Regression analysis to examine associations between evaluation criteria and candidacy outcome.
Main Results:
- Only 17 (23%) of 73 potential candidates were selected for cochlear implantation.
- Hearing compliance, behavior, medical contraindications, and family commitment were associated with candidacy outcome.
- Multivariate logistic regression identified family commitment as the sole significant predictor (OR 44.7, p<0.005).
Conclusions:
- Family commitment emerged as the critical, modifiable factor in cochlear implant candidate selection.
- Interventions addressing family commitment could potentially increase the number of eligible pediatric cochlear implant recipients.
- Optimizing patient selection through understanding modifiable factors is essential for improving access to cochlear implants.
Introduction:
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.
Materials And Methods:
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.
Results:
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).
Conclusion:
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.
