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Updated: Jul 3, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cognitive and language outcomes for pediatric hearing loss with otologic surgery
Natalie M Perlov1, Marwin Li1, Jena Patel2
1Sidney Kimmel Medical College, Philadelphia, PA, USA.
Insights
Surgical otologic intervention for pediatric hearing loss significantly reduces the risk of adverse cognitive and linguistic developmental delays. This finding supports considering surgical options for improved child development outcomes.
Area of Science:
- Pediatric Otolaryngology
- Developmental Pediatrics
- Audiology
Background:
- Pediatric hearing loss (HL) can lead to adverse cognitive and linguistic developmental outcomes.
- Surgical interventions are available for various types of pediatric HL.
Purpose of the Study:
- To evaluate if surgical otologic intervention for pediatric hearing loss decreases the likelihood of adverse cognitive and linguistic developmental outcomes.
Main Methods:
- Retrospective cohort study using TriNetX Research Network data.
- Included children aged 0-5 years with congenital, sensorineural, conductive, or mixed HL.
- Propensity-score matching balanced cohorts based on demographics and congenital conditions.
Main Results:
- Analysis of 457,636 children; 118,576 underwent surgery.
- Surgical intervention significantly decreased odds of cognitive disorders, developmental delays, and psychological disorders (p < 0.01).
Conclusions:
- Surgical interventions for pediatric HL, including cochlear implantation and tympanoplasty, may prevent developmental delays.
- These surgical options should be considered for children with hearing loss.
Objectives:
To test the hypothesis that surgical otologic intervention for any type of pediatric hearing loss decreases the odds for incident adverse cognitive and linguistic developmental outcomes.
Study Design:
Retrospective cohort database study.
Methods:
Electronic medical record data from the TriNetX Research Network were queried for children with congenital, sensorineural, conductive, and mixed hearing loss (HL) between ages 0 and 5 years. Patients were further stratified by presence (HL + surgery) or absence (HL-surgery) of surgical intervention at any point following diagnosis, including cochlear implantation, tympanoplasty with or without mastoidectomy, and tympanostomy. Primary outcomes were defined as odds for new adverse cognitive or linguistic outcomes at any point given HL treatment status [odds ratio with 95% confidence interval, (OR; 95%CI, p-value)]. Cohorts were balanced using propensity-score matching (PSM) based on US census-defined demographics and clinically relevant congenital conditions.
Results:
Of 457,636 total patients included in the study, 118,576 underwent surgery (HL + surgery cohort) and 339,060 did not (HL-surgery). In matched cohorts, surgical otologic intervention significantly decreased the odds of developing cognitive disorders including scholastic, motor, psychological developmental disorders, and pervasive developmental delays (p < 0.01).
Conclusions:
Surgical interventions for treatment of pediatric HL including cochlear implantation, tympanoplasty with or without mastoidectomy, and tympanostomy should be considered as they may prevent delays in development.
