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Published on: October 11, 2024
Long-Term Functional Hearing Preservation in Pediatric Cochlear Implant Recipients
Lisa R Park1, Margaret E Richter, Amanda D Sloop
1Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
Summary
Functional hearing preservation (FHP) is achievable in pediatric cochlear implant recipients, with outcomes influenced by electrode array length and inner ear malformations. Hearing preservation declines over time, especially with enlarged vestibular aqueduct (EVA).
Area of Science:
- Audiology
- Otolaryngology
- Pediatric Medicine
Background:
- Pediatric cochlear implantation aims to restore hearing, but preserving residual acoustic hearing is crucial for optimal outcomes.
- Functional hearing preservation (FHP) in children receiving cochlear implants (CIs) requires careful consideration of surgical factors and patient-specific anatomy.
Purpose of the Study:
- To evaluate long-term functional hearing preservation (FHP) in pediatric cochlear implant recipients.
- To identify key predictors of FHP, including electrode array length, preoperative hearing thresholds, and the presence of inner ear malformations like enlarged vestibular aqueduct (EVA).
Main Methods:
- Retrospective case review of 113 pediatric CI recipients with preoperative acoustic hearing.
- Data analysis included Kaplan-Meier survival analysis and mixed-effects modeling over a mean follow-up of 4 years.
- Functional hearing preservation (FHP) was defined as an unaided threshold of ≤80 dB HL at 250 Hz.
Main Results:
- Overall FHP survival estimates were 0.70 at 1 year and 0.57 at 5 years.
- Children with enlarged vestibular aqueduct (EVA) showed significantly poorer hearing preservation compared to those without EVA.
- Hearing preservation was significantly influenced by electrode array length, preoperative thresholds, EVA presence, and time since surgery.
Conclusions:
- Functional hearing preservation is attainable in a significant portion of pediatric CI recipients, especially with 24 mm electrode arrays and without inner ear malformations.
- Hearing outcomes progressively decline over time, particularly in cases with EVA, necessitating tailored management strategies.
- Long-term monitoring and individualized surgical and rehabilitation approaches are essential for optimizing hearing outcomes in pediatric CI recipients.