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Early Auditory Stimulation, Not Device Type: Comparable Cortical Maturation in Children Using Cochlear Implants or
Koray Tumuklu1, Behcet Gunsoy2
1Department of Otolaryngology, Private Clinic, 27310 Gaziantep, Turkey.
Insights
Early intervention with unilateral cochlear implants (CIs) or bilateral hearing aids (HAs) in children with congenital hearing loss showed similar cortical auditory maturation. Optimized fitting before 48 months supports auditory development, regardless of device type.
Area of Science:
- Audiology
- Neuroscience
- Pediatrics
Background:
- Congenital severe-to-profound sensorineural hearing loss impacts auditory development.
- Cortical auditory evoked potentials (CAEPs), specifically P1 latency, are key indicators of auditory pathway maturation.
- Comparing cochlear implants (CIs) and hearing aids (HAs) is crucial for optimizing rehabilitation strategies.
Purpose of the Study:
- To compare cortical auditory maturation, assessed by P1 latency, in children with congenital hearing loss using unilateral CIs versus bilateral HAs.
- To investigate the influence of early device fitting and aided thresholds on auditory development.
Main Methods:
- Retrospective study of 85 children with congenital severe-to-profound hearing loss, divided into unilateral CI (n=42) and bilateral HA (n=43) groups.
- All participants received devices before 48 months with aided free-field thresholds between 30-50 dB HL.
- CAEPs were recorded using speech stimuli, and P1 latency was analyzed and compared between groups.
Main Results:
- No significant difference in P1 latency was found between the CI and HA groups for any speech stimulus (/m/, /g/, /t/).
- Age at device fitting was comparable between groups.
- Despite longer device use duration in the HA group, no correlation was observed between duration of use and P1 latency.
Conclusions:
- Unilateral cochlear implantation and bilateral hearing aids demonstrate comparable P1 latency, indicating similar cortical auditory maturation when fitted early and optimally.
- Early and adequate auditory stimulation is vital for supporting auditory development in children with congenital hearing loss.
- Clinical management should consider individual patient needs and optimize device fitting for best outcomes.
Abstract:
Introduction: The present study aimed to compare cortical auditory maturation, as reflected by P1 latency of cortical auditory evoked potentials (CAEPs), in children with congenital severe-to-profound sensorineural hearing loss rehabilitated with unilateral cochlear implants (CIs) or bilateral conventional hearing aids (HAs). Materials and Methods: Eighty-five children with congenital severe-to-profound sensorineural hearing loss were included in this retrospective comparative study. Participants were divided into two groups: unilateral CI users (n = 42) and bilateral HA users (n = 43). All children were fitted with their devices before 48 months of age and achieved aided free-field thresholds between 30 and 50 dB HL. CAEPs were recorded using the Fonix® HEARLab System with speech stimuli (/m/, /g/, /t/) presented at 55 dB SPL. P1 latency values were measured and compared between groups using independent samples t-tests. Correlation analyses were performed to assess the relationship between duration of device use and P1 latency. Results: Eighty-five children were included (CI: n = 42; HA: n = 43). Mean P1 latency values did not differ significantly between groups for the /m/ stimulus (126.4 ± 29.13 ms vs. 126.4 ± 29.28 ms, p = 1.00), /g/ stimulus (106.5 ± 26.46 ms vs. 110.1 ± 29.49 ms, p = 0.55), or /t/ stimulus (114.7 ± 22.93 ms vs. 118.5 ± 27.19 ms, p = 0.48). Age at device fitting was comparable between groups (27.95 ± 9.10 vs. 26.88 ± 14.15 months, p = 0.68). The duration of device use was significantly longer in the HA group (48.02 ± 28.39 months) compared to the CI group (26.00 ± 15.92 months) (p < 0.001). Correlation analysis revealed no significant association between duration of device use and P1 latency for any stimulus (/m/: p = 0.28; /g/: p = 0.17; /t/: p = 0.09). Conclusions: When devices were fitted before 48 months of age and aided thresholds were optimized, unilateral cochlear implantation and bilateral conventional hearing aids showed comparable P1 latency values as an index of cortical auditory maturation. These findings suggest that early and adequate auditory stimulation may play an important role in supporting cortical auditory development in children with congenital hearing loss, although results should be interpreted within the context of individualized clinical management.
