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Published on: March 24, 2023
Cochlear Implantation for Single-Sided Deafness in Pediatric Patients: A Critical Assessment of Usage Rate
Robert J Macielak1, Celine Richard2, Prashant S Malhotra3
1Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Insights
Pediatric cochlear implantation (CI) for single-sided deafness (SSD) shows audiometric benefits, but device usage rates remain low. Further assessment is needed to understand and improve CI utilization in children with SSD.
Area of Science:
- Audiology
- Otolaryngology
- Pediatric Medicine
Background:
- Single-sided deafness (SSD) in children presents unique challenges for auditory rehabilitation.
- Cochlear implantation (CI) is an option for restoring hearing in pediatric SSD, but its effectiveness and usage require evaluation.
Purpose of the Study:
- To assess the usage rates of pediatric patients who received cochlear implantation (CI) for single-sided deafness (SSD).
Main Methods:
- Retrospective cohort study at a tertiary care pediatric referral center.
- Included pediatric patients who underwent CI for SSD with audiometric follow-up.
- Evaluated device use and audiometric outcomes.
Main Results:
- 66 pediatric patients underwent CI for SSD; 18% were lost to follow-up.
- Of 54 patients with follow-up, only 19% were high-level users (≥6 h/day), and 24% were limited users.
- 85% of tested patients showed speech-in-noise improvement with CI, yet 36% of these were non-users.
Conclusions:
- Pediatric CI for SSD provides audiometric benefits but has unexpectedly low usage rates.
- No specific factors were identified to explain the low usage, necessitating critical review of resource allocation and patient support.
Objective:
To assess the usage rate of pediatric patients undergoing cochlear implantation (CI) for single-sided deafness (SSD).
Study Design:
Retrospective cohort study.
Setting:
Tertiary care pediatric referral center.
Patients:
Pediatric patients who underwent CI for SSD.
Interventions:
CI with requisite audiometric follow-up.
Main Outcome Measures:
Device use and audiometric testing.
Results:
Sixty-six patients were implanted for SSD between 8/2015 and 7/2023 at a median age of 4.7 years (interquartile range, 1.7-7.7 yr). The cause of hearing loss was unknown in the majority of cases (28 patients, 42%), with cytomegalovirus being the most common known cause (17 patients, 26%). Hearing loss was prelingual in 38 patients (58%). Post-implantation, 12 patients (18%) were identified as lost to follow-up. For the remaining 54 patients, the median length of audiometric follow-up was 1.4 years (interquartile range, 0.9-2.2 yr). At last evaluation, only 10 of these 54 patients (19%) were designated as users (≥6 h per day), and 13 patients (24%) were designated as limited users (>2 but <6 h per day). Of patients capable of performing speech-in-noise testing (n = 13), 11 patients (85%) showed improvement on BKB-SIN SNR-50 testing with their implant on versus off with a mean improvement of 3 dB. Notably, 4 of these 11 patients (36%) were categorized as nonusers despite this benefit.
Conclusions:
Despite audiometric benefit from CI in the pediatric SSD population, usage rates over time remain markedly lower than anticipated at a high-volume, well-resourced tertiary care pediatric center. No influencing factors were identified, warranting critical assessment to ensure appropriate resource allocation.
