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Updated: Jun 17, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Factors impacting outcomes of cochlear implantation in children at two University centres in China: Multi-year
Chongxian Yu1, Jianfen Luo2,3, Mei Zhong1
1Department of Otolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Insights
Younger age at cochlear implantation (CI) and bilateral device use significantly improve hearing outcomes in children. Parental expectations also play a role in functional hearing performance.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Rehabilitation Medicine
Background:
- Paediatric cochlear implantation (CI) is a crucial intervention for severe to profound hearing loss.
- Understanding factors influencing functional hearing and quality of life (QoL) is vital for optimizing outcomes.
- Limited data exists on these factors in Chinese paediatric CI populations.
Purpose of the Study:
- To identify factors affecting functional hearing performance and QoL in paediatric CI recipients.
- To analyze the impact of age at implantation, device usage, and parental expectations on outcomes.
- To provide insights for families, professionals, and health authorities.
Main Methods:
- Prospective longitudinal study (P-IROS) involving 288 children under 10 years old at two Chinese university centers.
- Data collected pre-implantation and at 6-month intervals for 2 years post-implantation.
- Functional hearing (Categories of Auditory Performance-II) and QoL measures analyzed using ordinal mixed-effects regression models.
Main Results:
- Younger age at implantation and pre-implantation hearing aid use were associated with significant benefits.
- Bilateral CI or bimodal users showed significantly better functional hearing than unilateral users.
- Lower parental expectations correlated with slower functional hearing improvements; QoL improved over time but varied between centers.
Conclusions:
- All participants showed significant improvements in auditory performance and QoL.
- Earlier improvements were linked to younger age at CI and bilateral/bimodal device fitting.
- Aetiology of hearing loss and maternal education level are also important considerations for device choice and support.
Objectives:
To identify factors affecting functional hearing performance and quality of life (QoL) outcomes in paediatric cochlear implantation (CI) recipients at two University centres in mainland China.
Methods:
Two university centres in mainland China, part of the prospective longitudinal Paediatric Implanted Recipient Observational Study (P-IROS), contributed participant data. Participants were aged under 10 years at time of CI. Functional hearing performance and QoL measures were collected prior to device activation, and at 6-monthly intervals for 2 years post-implantation. Functional hearing endpoints including Categories of Auditory Performance-II (CAP-II) and QoL were evaluated and analysed using ordinal mixed-effects regression models.
Results:
Data were from 288 children with a mean age at implant of 2.74 years. Overall follow-up at 1 year was 59% and 51% at 2 years. Younger age at implantation (p<0.001) and hearing aid use preimplantation (p=0.026) were associated with significant benefit. Bilateral device users (both CI and bimodal) achieved significantly better functional hearing performance on the CAP-II than unilateral CI users (p<0.001). Slower functional hearing improvements were observed in those with lower parental expectations compared to higher expectations (p<0.001). QoL improved over time but followed a different initial trajectory between centres.
Conclusion:
All participants demonstrated significant improvements in auditory performance and QoL over time. Younger age at CI, and bilateral/bimodal device fitting contributed to earlier improvements. Other potential factors that could help inform families, professionals, and health authorities about choice of hearing device and educational supports required included aetiology of hearing loss and level of maternal education.
