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Updated: Jul 29, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear Implantation Outcomes in Pediatrics with Inner Ear Malformations in a Tertiary Care Hospital in Ahvaz
Mostafa Timar1,2, Nader Saki1,3, Arash Bayat1,4
1Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Insights
Cochlear implantation (CI) significantly improves auditory and speech performance in pediatric patients with inner ear malformations (IEMs). Specific IEM types like common cavity and IP-II show notable gains, indicating CI is a viable option after careful screening.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Cochlear implantation (CI) offers significant benefits for sensorineural hearing loss (SNHL).
- Inner ear malformations (IEMs) present unique challenges for auditory rehabilitation.
- Assessing CI outcomes in pediatric IEM populations is crucial for treatment planning.
Purpose of the Study:
- To evaluate the auditory and speech performance of pediatric patients with IEMs after cochlear implantation.
- To compare the outcomes of CI across different types of inner ear malformations.
- To determine if specific IEMs contraindicate cochlear implantation.
Main Methods:
- Retrospective study of 22 pediatric patients with congenital IEMs undergoing CI (2014-2019).
- Classification of IEMs via CT-Scan: Incomplete Partition (IP)-I, IP-II, and common cavity.
- Assessment of auditory performance using the Category of Auditory Performance (CAP) scale and speech intelligibility using the Speech Intelligibility Rating (SIR) scale.
Main Results:
- Significant improvements in median CAP scores from 0.5 preoperatively to 3.5 postoperatively (p=0.036).
- Significant improvements in median SIR scores from 1 preoperatively to 2 postoperatively (p=0.001).
- Statistically significant CAP and SIR score differences were observed between pre- and post-operative evaluations in common cavity and IP-II groups.
Conclusions:
- Cochlear implantation is a beneficial treatment for pediatric patients with specific inner ear malformations.
- Patients with common cavity and IP-II malformations demonstrate significant auditory and speech performance gains post-CI.
- Thorough preoperative screening is essential to identify suitable candidates for CI among pediatric IEM populations, as IEMs are not absolute contraindications.
Abstract:
Cochlear implantation (CI) has been successful in individuals with sensorineural hearing loss (SNHL) over the last few years. This study assessed the auditory and speech performance results of pediatrics with inner ear malformations (IEMs) following cochlear implantation at the Ahvaz cochlear implantation center and compared the outcomes of various malformations. All pediatrics with IEMs undergoing CI were included in the study. This retrospective study was performed on pediatrics with congenital IEMs who underwent cochlear implantation in Ahvaz cochlear implantation center between 2014 and 2019. The Category of Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) scores are two of the most frequently administered tests. The CAP with ranging from 0 (displays no awareness of environmental sounds) to 7 (can use the telephone with a familiar talker), was used to measure the speech perception performance of the implanted children. Furthermore, SIR consists of five performance categories ranging from "prerecognizable words in spoken language" to "connected speech is intelligible to all listeners". Finally, the study included 22 patients. The evaluation of the CT-Scan revealed three types of inner ear malformation: Incomplete Partition (IP)-I in 2 (9.1%), IP-II in 12 (54.5%), and common cavity in 8 (36.4%) individuals. The results were shown that the median CAP score preoperative was 0.5 (interquartile range (IQR): 0-2) and postoperative was 3.5 (IQR: 3-7). There were statistically significant differences in CAP scores between preoperative and second-year follow-up postoperative (p value = 0.036). The results were shown that the median SIR score preoperative was 1 (IQR: 1-5) and postoperative was 2 (IQR: 1-5). There were statistically significant differences in SIR scores between preoperative and second-year follow-up postoperative (p value = 0.001). Following a thorough preoperative screening, patients with specific IEMs can be candidates for CI and not a contraindication. There were statistically significant differences in CAP and SIR scores between preoperative and second-year follow-up postoperative in the common cavity and IP-II groups.
