Related Experiment Video
Updated: Jul 29, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear Implantation in Very Young Children With Single-Sided Deafness
Ankita Patro1, Jourdan T Holder1,2, Christine L Brown2
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
Cochlear implants (CIs) are safe and effective for children under five with single-sided deafness (SSD), showing significant speech benefits. Early implantation is well-accepted and beneficial, especially for those without cochlear nerve issues or developmental delays.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Current cochlear implant (CI) approvals for single-sided deafness (SSD) exclude children under five, despite potential benefits.
- This study investigates the safety and efficacy of CI in younger children with SSD.
Purpose of the Study:
- To evaluate the institution's experience with cochlear implantation for single-sided deafness in children aged five years and younger.
- To assess the safety, device usage, and speech outcomes in this pediatric population.
Main Methods:
- A retrospective case series was conducted using chart review.
- Nineteen patients aged five years and younger with SSD underwent cochlear implantation between 2014 and 2022.
- Data collected included baseline characteristics, perioperative complications, device use, and speech outcomes.
Main Results:
- Fifteen of nineteen patients (79%) were under five years old at implantation, with a median age of 2.8 years.
- No postoperative complications were reported.
- Twelve patients demonstrated consistent device use (average 9 hours/day), and those with available testing showed significant speech recognition benefits.
Conclusions:
- Cochlear implantation is a safe and viable option for children under five with single-sided deafness.
- Early implantation is well-tolerated and leads to notable improvements in speech recognition.
- Candidacy for CI in SSD could be expanded to include younger children, particularly those without contraindications like hypoplastic cochlear nerves or developmental delays.
Objective:
Cochlear implants (CIs) for single-sided deafness (SSD) have only been approved for patients 5 years and older despite data supporting that younger children can also benefit from implantation. This study describes our institution's experience with CI for SSD in children 5 years and younger.
Study Design:
Case series with chart review.
Setting:
Tertiary referral center.
Methods:
A case series with chart review identified 19 patients up to age 5 years who underwent CI for SSD between 2014 and 2022. Baseline characteristics, perioperative complications, device usage, and speech outcomes were collected.
Results:
The median age at CI was 2.8 (range, 1.0-5.4) years, with 15 (79%) patients being below age 5 at implantation. Etiologies of hearing loss were idiopathic (n = 8), cytomegalovirus (n = 4), enlarged vestibular aqueduct (n = 3), hypoplastic cochlear nerve (n = 3), and meningitis (n = 1). The median preoperative pure-tone average was 90 (range, 75-120) and 20 (range, 5-35) dB eHL in the poor and better hearing ears, respectively. No patients had postoperative complications. Twelve patients achieved consistent device use (average, 9 h/d). Three of the seven who were not consistent users had hypoplastic cochlear nerves and/or developmental delays. The three patients with available preoperative and postoperative speech testing showed significant benefits, and five patients with available postoperative testing demonstrated speech recognition in the implanted ear when isolated from the better ear.
Conclusion:
CI can safely be performed in younger children with SSD. Patients and families accept early implantation, as evidenced by consistent device use, and derive notable benefits in speech recognition. Candidacy can be broadened to include SSD patients under age five years, particularly individuals without hypoplastic cochlear nerves or developmental delay.
