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Auditory Outcomes of Cochlear Implantation among Pediatric Patients under the Philippine National Cochlear Implant
Nhor Albert C Robles1, Charlotte M Chiong1,2, Karen Joyce S Velasco1
1Department of Otolaryngology-Head and Neck Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Insights
The National Cochlear Implant Program (NCIP) shows promising results for pediatric hearing loss. Factors like normal preoperative imaging and ideal electrode placement significantly improve auditory outcomes in cochlear implant (CI) recipients.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Medical Devices
Background:
- The National Cochlear Implant Program (NCIP) in the Philippines addresses rising hearing loss, particularly in children.
- Pilot implementation involved three tertiary hospitals and 20 successful cochlear implant (CI) surgeries.
Purpose of the Study:
- To evaluate the auditory outcomes of CI patients enrolled in the NCIP.
- Utilized the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) Questionnaire and Categories of Auditory Performance (CAP) score.
Main Methods:
- Retrospective cohort study of 19 CI recipients from December 2019 to December 2021.
- Assessed PEACH and CAP scores, comparing outcomes with patient demographics, socioeconomic status, hearing aid use, pre-CI imaging, and electrode placement.
- Employed nonparametric statistical tests for analysis.
Main Results:
- Mean PEACH score was 53.59% ± 12.76%; mean CAP score was 3.16 ± 1.04.
- Higher PEACH scores correlated with higher parental education (p=0.017) and ideal scala tympani electrode placement (p=0.012).
- Normal preoperative imaging significantly improved CAP scores (p=0.013).
Conclusions:
- Normal preoperative imaging, correct electrode placement, and higher parental education are linked to better auditory outcomes post-CI.
- While earlier CI (<36 months) and longer hearing aid use showed trends towards improvement, these were not statistically significant.
- Further research with larger sample sizes is recommended to validate findings.
Background:
The National Cochlear Implant Program (NCIP) is a national program that addresses the increasing prevalence of hearing loss, especially in the pediatric population here in the Philippines. In its pilot implementation, it included three tertiary hospitals to represent Luzon, Visayas, and Mindanao, and was able to enroll 20 patients who successfully underwent cochlear implantation (CI).
Objectives:
The aim of this study is to evaluate the auditory outcomes of the patients who underwent cochlear implantation under the NCIP using the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) Questionnaire and Categories of Auditory Performance (CAP) score questionnaire.
Methods:
This is a retrospective cohort study including all recipients of the cochlear implants, under NCIP from December 2019 to December 2021, except one with incomplete data during the course of his follow up. The outcomes measured included the PEACH Questionnaire score and CAP Questionnaire score and were compared on various factors which included patient's sex and age, parents' socioeconomic status, duration of hearing aid use prior to CI, pre-CI imaging findings, and CI electrode placement using nonparametric statistical tests.
Results:
The mean PEACH score of the 19 patients was 53.59% ± 12.76% (range: 30% - 75%) while the mean CAP score was 3.16 ± 1.04 (range: 1 - 4.3). Parents of the included patients who have a higher educational background and those in which the electrode was located on the ideal location, scala tympani, have a statistically significant higher PEACH score (p-value of 0.017 and 0.012, respectively). In comparing the CAP scores, those who have unremarkable or normal preoperative imaging have a statistically significant higher score (p-value 0.013).
Conclusion:
Patients who had normal preoperative imaging, proper placement of electrodes, and those patients with parents belonging to a higher educational background had statistically significant better auditory outcomes after cochlear implantation. Patients who had the cochlear implantation before 36 months of age and hearing aid use of 7 to 18 months prior to cochlear implantation had higher PEACH and CAP scores, however these were not statistically significant. Further studies with a larger sample size is recommended.
