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Risk prediction model for adverse outcomes during and after cochlear implantation in children with inner ear
Kunjun Li1, Ruhuan Zhou1, Wenwen Zheng1
1Department of Otorhinolaryngology Head and Neck Surgery, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China.
Insights
This study developed age-specific models to predict adverse outcomes in children undergoing cochlear implantation (CI) for inner ear abnormalities. These tools aid in assessing risks and counseling for better surgical planning.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Imaging
Background:
- Inner ear abnormalities present unique challenges for pediatric cochlear implantation (CI).
- Adverse outcomes during and after CI can significantly impact patient recovery and long-term results.
- Accurate risk prediction is crucial for optimizing surgical planning and patient counseling.
Purpose of the Study:
- To develop and validate age-specific risk prediction models for adverse outcomes in children with inner ear abnormalities undergoing CI.
- To identify key factors associated with adverse events across different pediatric age groups.
- To provide tools for enhanced perioperative risk assessment and counseling.
Main Methods:
- Retrospective analysis of 609 children with inner ear abnormalities who underwent CI.
- Patients categorized into three age groups: <3, 3-6, and >6 years.
- Stepwise regression and bootstrap resampling used for model development and internal validation.
Main Results:
- Three predictive models were constructed for the age groups <3, 3-6, and >6 years.
- Predictive factors varied by age, including cochlear ossification, surgical time, and specific malformations (e.g., cochlear hypoplasia, incomplete partition).
- Models demonstrated moderate discriminative ability (AUCs ranging from 0.68 to 0.75).
Conclusions:
- Age-specific nomograms were developed to predict adverse CI outcomes in pediatric patients with inner ear abnormalities.
- These models offer moderate predictive power for age-specific risk assessment.
- The nomograms can serve as valuable exploratory tools for perioperative counseling.
Background:
To construct a risk prediction model for adverse outcomes during and after cochlear implantation (CI) in children of different ages with inner ear abnormalities.
Methods:
This retrospective study included children with inner ear abnormalities (including large vestibular aqueduct syndrome, incomplete partition, cochlear hypoplasia, and cochlear common cavity malformation) who underwent CI from January 2011 to December 2023 at the First Affiliated Hospital of Anhui Medical University. The patients were divided into two groups based on the occurrence of adverse outcomes during the perioperative and postoperative periods. The patients were divided into age groups (<3, 3-6, and >6 years) to construct three predictive models. Baseline data were collected. Stepwise regression analysis was performed using the entire dataset, and internal validation was carried out using bootstrap resampling.
Results:
This study analyzed 609 children with inner ear abnormalities, divided into three age groups: <3, 3-6, and >6 years. Adverse outcomes were associated with various factors, including cochlear ossification, longer surgical time, cochlear hypoplasia, and cochlear common cavity malformation in the <3-year group (AUC = 0.68). In the 3-6-year group, factors included mastoiditis, middle ear malformation, cochlear ossification, and incomplete partition (AUC = 0.75). In the >6-year group, associations were found with middle ear malformation, cochlear ossification, and a high jugular bulb (AUC = 0.69).
Conclusions:
This study developed three nomograms for predicting adverse CI outcomes in patients aged <3, 3-6, and >6 years. These models demonstrate moderate discriminative ability and may serve as exploratory tools to assist in age-specific risk assessment and perioperative counseling for children with inner ear abnormalities.
