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Cochlear Implant Surgery and Electrically-evoked Auditory Brainstem Response Recordings in C57BL/6 Mice
Published on: January 9, 2019
Neurobehavioral effects of general anesthesia and cochlear implantation on hearing-impaired infants: A prospective
Li Ma1, Yue Yu1, Xuhui Zhou1
1Department of Anaesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Bilateral cochlear implantation in infants with severe-to-profound hearing loss showed greater language improvement than unilateral implantation, despite longer anesthesia exposure. No significant differences were found in other developmental skills.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Developmental Pediatrics
Background:
- Prolonged anesthetic exposure risks in pediatric sensorineural hearing loss are unclear.
- This study investigates developmental outcomes of unilateral versus bilateral cochlear implantation in infants.
Purpose of the Study:
- To compare developmental impairments in infants with severe-to-profound sensorineural hearing loss undergoing unilateral or bilateral cochlear implantation.
- To assess the impact of anesthesia duration on developmental outcomes.
Main Methods:
- Prospective observational study of 90 infants (6 months-2 years) with bilateral severe-to-profound sensorineural hearing loss.
- Gesell Scale scores measured at baseline, 6 months, and 1 year post-surgery.
- Outcomes assessed: fine motor, adaptability, gross motor, language, and social skills.
Main Results:
- Bilateral cochlear implantation group had longer anesthesia duration but showed significantly greater language score improvements at 6 and 12 months.
- No significant differences in fine motor, gross motor, adaptability, or social skills between groups.
- Language development positively correlated with baseline scores and bilateral implantation.
Conclusions:
- Bilateral cochlear implantation in infants with severe-to-profound sensorineural hearing loss leads to enhanced language development compared to unilateral implantation.
- Longer anesthesia exposure in bilateral cases did not result in greater overall developmental impairment.
- Early bilateral cochlear implantation is a safe and effective option for improving language outcomes.
Introduction:
The potential adverse effects of prolonged exposure to anesthetics in pediatric patients with severe-to-profound sensorineural hearing loss remain unclear. This study aimed to examine whether early bilateral cochlear implantation involving long-duration anesthetic exposure caused greater developmental impairment than that with unilateral cochlear implantation.
Methods:
This prospective observational study included normally developing infants with bilateral severe-to-profound sensorineural hearing loss aged 6 months to 2 years who were candidates for unilateral/bilateral cochlear implantation surgery. Baseline (T0), 6-month (T1), and 1-year (T2) Gesell Scale scores were measured. The outcomes included fine motor, adaptability, gross motor, language, and social skills scale 6 and 12 months postoperatively.
Result:
The 90 enrolled children with bilateral severe-to-profound sensorineural hearing loss (unilateral n = 43; bilateral n = 47) had a younger bilateral group (11.00 ± 3.66 vs. 15.63 ± 6.99 months, p < .001). Anesthesia duration was longer in the bilateral group (271.57 ± 36.09 vs. 148.81 ± 25.60 min, p < .001). Gross motor, fine motor, adaptability, and language scores improved in both groups, and no significant between-group differences occurred in the fine motor scale at T1 and T2. Language developmental quotients improved significantly in the bilateral group compared with the unilateral group at T1 (mean differences: 25.07 ± 4.37 vs. 10.88 ± 4.61, p < .001) and T2 (mean differences: 34.98 ± 5.94 vs. 15.28 ± 6.55, p < .001). Stepwise regression revealed that gross motor, adaptability, language, and social skill developmental quotients at T1 were positively correlated with those at T0. Gross motor, fine motor, and social skill developmental quotients at T2 were negatively correlated with age at operation. Language developmental quotients were positively correlated with T0 values (p < .001) and in the bilateral group (p < .001) at T1 and T2.
Conclusions:
When evaluating young children with bilateral severe-to-profound sensorineural hearing loss, despite longer exposures to general anesthesia, bilateral cochlear implantations were associated with more improvement in language scores and no differences in other skills compared with those with only unilateral implantation.
