フィロプロジェニティブ家族における人工内耳の長期予後：格差への対応
Amit Wolfovitz1,2, Arad Dotan2, Shibli Sleibi1,2
1Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan.
Background:
In recent years, the critical role of parental involvement in the success of pediatric cochlear implants (CIs) has become increasingly evident. However, the impact of family structure-specifically, the presence of multiple CI-using siblings and CI-experienced parents-on outcomes is not fully understood. Investigating these dynamics has the potential to improve auditory rehabilitation strategies in complex family settings.
Objective:
This study aims to evaluate the influence of the number of siblings with CIs and parental CI experience on pediatric speech perception outcomes following cochlear implantation.
Methods:
We retrospectively collected data from 2018 to 2023 on families with multiple pediatric CI recipients and a control group comprising families with a single CI child. The analysis focused on evaluating the effects of sibling number, birth order, and parental CI experience on speech perception outcomes 5 years postimplantation. The primary outcome was the speech perception score, measured using the Hebrew version of the Arthur Boothroyd word test (HAB), a validated word recognition test. A multivariate analysis was conducted to evaluate the impact of various factors on speech perception outcomes, accounting for potential confounders within this intricate context.
Results:
The cohort included 140 children, 102 from 41 philoprogenitive families (a mean of 3 siblings per family, range 2 to 6), and 38 children from families with a single CI recipient as controls. The presence of fewer CI-recipient siblings was associated with significantly better speech perception outcomes 5 years postimplantation (P=0.03). Children with CI-experienced parents had an earlier median age at surgery (1.1 vs. 1.8 y, P=0.017) and significantly improved speech perception scores (17.2, 95% CI: 0.48-33.8, P=0.04).
Conclusions:
Fewer siblings with CIs and the presence of CI-experienced parents were associated with earlier intervention and better speech outcomes. These findings highlight the need for a family-centered approach to cochlear implantation to address disparities and enhance outcomes in pediatric CI recipients.
