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Updated: Jun 25, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear implantation in pediatrics: Impact of newborn hearing screening on intervention time
Noura Alothman1, Yassin Abdelsamad2, Fida Almuhawas3
1Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Insights
The newborn hearing screening (NHS) program in Saudi Arabia significantly speeds up cochlear implantation (CI) for children with hearing loss. While screening improves early intervention, further research is needed to reduce hospital delays before CI surgery.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Public Health
Background:
- Newborn hearing screening (NHS) is crucial for early identification and intervention of hearing loss (HL).
- Saudi Arabia implemented its national NHS in 2016.
- The impact of NHS on cochlear implantation (CI) timing in Saudi Arabia and potential hospital delays are not well understood.
Purpose of the Study:
- To evaluate the effect of the implemented NHS on the age of CI in children with prelingual deafness.
- To assess hospital-related timing within the CI process in Saudi Arabia.
Main Methods:
- Retrospective review of pediatric CI recipients (2015-2022) at a tertiary center.
- Data collected included date of birth, date of presentation to the CI committee (CIC), and date of CI surgery (DOCIS).
- Comparison of age at CIC presentation and CI surgery between children screened via NHS and those born before its implementation.
Main Results:
- 304 children were analyzed; 55% were screened through NHS.
- Children screened via NHS presented to the CIC and received CI significantly earlier (P < 0.0001).
- No significant difference in time from CIC presentation to CI surgery was found between screened and unscreened groups (P > 0.05).
Conclusions:
- NHS implementation positively impacts age at CIC presentation and CI surgery.
- NHS does not reduce the time between CIC evaluation and the actual CI surgery.
- Further research is required to minimize hospital delays and optimize early CI for children.
Objectives:
The newborn hearing screening (NHS) program was globally established for early hearing loss (HL) identification and intervention. Early intervention is essential to minimize or prevent the negative consequences of HL. In Saudi Arabia, the NHS was officially implemented in 2016. Currently, its impact on the timing of cochlear implantations (CIs) in Saudi Arabia remains unclear, and information on potential hospital-related delays affecting early implantation is lacking. Thus, this study aimed to evaluate the effect of implementing the NHS on age at CI in children with prelingual deafness in a CI center in Saudi Arabia, and to evaluate the hospital timing in the CI process.
Methods:
All pediatric CI users who presented for the first time to the CI committee (CIC) at a tertiary center and received their implants between 2015 and 2022 were enrolled in this study. Date of birth (DOB), date of presentation to the CI committee (DOCIC), and date of CI surgery (DOCIS) were retrospectively reviewed.
Results:
In total, 304 CI children were included in the analysis. Approximately 55 % of the children (n = 167) were screened for HL through the NHS, whereas 45 % of the children (n = 137) were born before the launch of the NHS. Both age at the presentation to the CIC (i.e. difference between DOCIC and DOB) and age at implantation (i.e. difference between DOCIS and DOB) were significantly earlier in children who were screened for HL through the NHS than those who were not screened (P < 0.0001). The time difference between the DOCIC and DOCIS was not significantly different between the screened and unscreened children (P > 0.05).
Conclusion:
The implementation of the NHS in the tertiary center has a significant positive effect on age at presentation to the CIC and age at implantation, but not on the actual CI surgery. Further research is needed to reduce the hospital delays before the actual surgery in order to increase the likelihood of children receiving implantation early in their life.
