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Published on: June 8, 2017
The impact of prematurity on cochlear implant outcomes: A case-control study
Idit Tessler1,2, Yehonatan Adler2,3, Nir A Gecel2
1Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel.
Insights
Cochlear implantation (CI) outcomes are similar for preterm- and term-born infants. However, low birth weight in preterm infants negatively impacts their speech perception after CI.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neonatology
Background:
- Preterm infants have a higher incidence of hearing loss.
- Cochlear implantation (CI) outcomes in preterm infants are not well-understood.
- Understanding CI outcomes in this population is crucial for audiological management.
Purpose of the Study:
- To compare long-term hearing outcomes in preterm- versus term-born infants after CI.
- To identify prognostic factors for hearing outcomes in preterm infants post-CI.
Main Methods:
- Retrospective case-control study comparing 35 preterm infants with two control groups of term infants (n=126).
- Groups included etiology-matched controls and controls with connexin-26 (GJB2) genetic hearing loss.
- Primary outcomes: long-term speech reception threshold (SRT) and Hearing in Noise Test (HINT) scores.
Main Results:
- Speech reception threshold (SRT) was comparable between preterm infants and etiology-matched term infants.
- Hearing in Noise Test (HINT) scores were similar across all groups.
- Low birth weight (<1000g) in preterm infants was associated with poorer word identification outcomes.
- Significant improvements in HINT scores over time were observed in all groups.
Conclusions:
- Preterm birth itself does not significantly affect speech perception outcomes following cochlear implantation.
- Low birth weight is a significant negative prognostic factor for language perception in preterm CI recipients.
- Further research into optimizing CI for very low birth weight preterm infants is warranted.
Objective:
Despite a higher prevalence of hearing loss in preterm-born infants, cochlear implantation (CI) outcome remains underexplored in this unique subpopulation. We aimed to compare long-term hearing outcomes between preterm- and term-born infants undergoing CI and identify prognostic factors of hearing outcomes among preterm infants post-CI.
Methods:
This retrospective case-control study compared preterm infants (study group) with two control groups who underwent CI: One group of term infants was matched for hearing loss etiology and the other group was comprised of term infants with a genetic etiology [connexin-26 (GJB2)], the benchmark for favorable CI outcomes. Subgroup analyses were based upon birth weight and gestational age. Primary outcomes included long-term speech reception threshold (SRT) and monosyllabic word identification (HAB) scores.
Results:
A total of 161 implanted ears were included: 35 (22%) in the study group, 63 (39%) in the etiology-matched control group, and 63 (39%) in the GJB2 group. SRT was significantly lower in the GJB2 group compared to the study group (p = 0.007) but not between the study and the etiology-matched control group (p = 0.79). HAB scores were comparable among the three groups. A subgroup analysis revealed significant differences in word identification by birth weight, particularly in the <1000 g group. A linear mixed model analysis indicated significant improvements in HAB scores over time for all groups (p < 0.0001), with comparable HAB progress (p = 0.98).
Conclusion:
Our findings suggest that prematurity does not significantly impact speech perception outcomes among CI recipients. Low birth weight in preterm infants, however, emerged as a negative prognostic factor for language perception outcomes.
