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Updated: Aug 8, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Complications and outcomes of cochlear implantation in children younger than 12 months: A multicenter study
Alimohamad Asghari1, Ahmad Daneshi2, Mohammad Farhadi2
1Skull Base Research Center, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Insights
Cochlear implantation (CI) in infants under 12 months is safe and effective, showing similar complication rates and auditory-speech benefits compared to older children. This supports early intervention for severe hearing loss.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Cochlear implantation (CI) improves auditory and speech skills in children with severe to profound hearing loss.
- The safety and efficacy of CI in children under 12 months remain debated compared to older pediatric populations.
Purpose of the Study:
- To compare surgical complications and auditory-speech development in children undergoing CI before 12 months versus those implanted between 12-24 months.
- To evaluate the impact of age at implantation on outcomes in pediatric hearing loss.
Main Methods:
- Multicenter study of 86 children (<12 months, group A) and 362 children (12-24 months, group B) who received CI.
- Assessment of surgical complications and Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores at baseline, 1-year, and 2-year post-implantation.
Main Results:
- No statistically significant difference in overall complication rates between group A (4.65%) and group B (4.41%).
- Both groups showed significant improvements in CAP and SIR scores over time.
- No significant differences in CAP and SIR scores were observed between the age groups at any time point.
Conclusions:
- Cochlear implantation in children under 12 months is a safe and effective procedure.
- Infants undergoing CI experience similar complication rates and achieve comparable auditory-speech benefits to older children.
Objectives:
Evidence suggests that Cochlear Implantation (CI) is a beneficial approach for auditory and speech skills improvement in children with severe to profound hearing loss. However, it remains controversial if implantation in children <12 months is safe and effective compared to older children. The present study aimed to determine whether children's ages affect surgical complications and auditory and speech development.
Methods:
The current multicenter study enrolled 86 children who underwent CI surgery at <12 months of age (group A) and 362 children who underwent implantation between 12 and 24 months of age (group B). The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were determined pre-impanation, and "one-year" and "two-year" post-implantation.
Results:
All children had full insertions of the electrode array. Four complications (overall rate: 4.65%; three minor) occurred in group A and 12 complications (overall rate: 4.41%; nine minor) occurred in group B. We found no statistically significant difference in the complication rates between the groups (p > 0.05). The mean SIR and CAP scores improved over time following CI activation in both groups. However, we did not find significant differences in CAP and SIR scores between the groups across different time points.
Conclusion:
Cochlear implantation in children younger than 12 months is a safe and efficient procedure, providing substantial auditory and speech benefits. Furthermore, rates and nature of minor and major complications in infants are similar to those of children undergoing the CI at an older age.
