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Updated: Jul 5, 2025
Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Early cochlear implantation for children with single sided deafness
Emily R Spitzer1, Younes Attlassy2, J Thomas Roland1
1New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA.
Insights
Cochlear implants (CI) for children with single-sided deafness (SSD) show variable speech perception results. Early implantation may help, but outcomes depend on individual factors and anatomical considerations.
Area of Science:
- Pediatric audiology
- Neuroscience
- Otolaryngology
Background:
- Single-sided deafness (SSD) in children impacts language, education, and social development.
- Cochlear implants (CI) are the only option for binaural hearing restoration.
- Current US FDA approval for pediatric CI in SSD is limited to children over age five.
Purpose of the Study:
- To evaluate speech perception outcomes in children with SSD implanted at age five or younger.
- To determine the influence of implantation age, deafness duration, etiology, and comorbidities on CI outcomes.
- To assess device usage patterns in young children with SSD.
Main Methods:
- Retrospective chart review of 18 children implanted with CI at age five or younger.
- Analysis of demographic data and speech perception results.
- Examination of factors influencing device usage and audiological outcomes.
Main Results:
- Speech perception outcomes were highly variable, ranging from significant benefit to no sound awareness.
- Age at implantation and duration of deafness did not show a clear impact on results.
- Low device usage was observed, particularly in children with anatomical abnormalities like a hypoplastic cochlear nerve.
- Challenges exist in assessing speech perception in young children, with a lack of standardized measures.
Conclusions:
- Early CI implantation for pediatric SSD may offer speech perception benefits, but success is not universal.
- Candidacy evaluation requires a comprehensive approach, including medical, audiological, family support, and realistic expectations.
- Particular caution is advised for children with significant anatomical anomalies.
Objectives:
Single-sided deafness (SSD) can have consequences for a child's language, educational, and social development. A cochlear implant (CI) is the only device which can restore true binaural hearing, yet they are only approved for children with (SSD) over the age of five in the United States. Reports on speech perception outcomes for children implanted at a younger age are limited. The present study aims to examine the effects of age at implantation, duration of deafness, hearing loss etiology, and presence of additional disabilities on device usage and speech perception outcomes.
Methods:
A retrospective chart review was used to examine demographics and speech perception outcomes for 18 children implanted at age five or younger.
Results:
Speech perception results were highly variable, with some children deriving significant benefit and others demonstrating no sound awareness through the implant alone. Age at implantation and duration of deafness did not have a clear impact on outcomes. Device usage was low in many children, often those with anatomical abnormalities such as a hypoplastic cochlear nerve. There are challenges to assessing speech perception in young children with SSD, leading to a lack of standardized outcome measures.
Conclusions:
Early CI for children with SSD may improve speech perception, but benefit is not guaranteed. Candidacy evaluation should consider both medical and audiological factors, in addition to the degree of family support and realistic expectations. Caution is especially warranted in children with significant anatomical anomalies.
