Prelingual deafness: Benefits from cochlear implants versus conventional hearing aids

Bittencourt, Aline Gomes; Torre, Ana Adelina Giantomassi Della; Bento, Ricardo Ferreira; Tsuji, Robinson Koji; Brito, Rubens de

doi:10.7162/s1809-97772012000300014

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…Bittencourt et al reported that CI treatment is beneficial compared with treatment with conventional HAs for children with severe to profound HI. The authors based their conclusions on SPe and developmental data.…”

Section: Discussionmentioning

confidence: 99%

“…Substantial evidence shows that cochlear implantation is the preferred treatment for children presenting with profound hearing impairment (HI) (>90 decibel [dB] hearing level [HL]) . Owing to the clinical success of cochlear implantation in both the speech and language development (SLD) and audiologic rehabilitation of these children, there is discussion questioning whether children with severe HI (>70-90 dB HL) could also benefit from cochlear implantation.…”

Section: Introductionmentioning

confidence: 99%

“…This exposure during the sensitive period results in SLD; therefore, we used 4 SLD domains (speech production [SPr], speech perception [SPe], receptive language [RL], and auditory performance [AP]) to verify the modality of hearing rehabilitation that children with severe HI should receive. Because children with severe HI could possibly benefit from cochlear implantation, we performed a systematic review to identify audiologic thresholds (in dB HLs) as an audiologic candidacy criterion for cochlear implantation in these children. These thresholds could contribute to expanding the indication field for hearing rehabilitation using CIs and reduce ambiguity between national and manufacturer cochlear implantation guidelines.…”

Section: Introductionmentioning

confidence: 99%

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Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy

Kleijn

Kalmthout

Vossen

et al. 2018

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEAlthough current guidelines recommend cochlear implantation only for children with profound hearing impairment (HI) (>90 decibel [dB] hearing level [HL]), studies show that children with severe hearing impairment (>70-90 dB HL) could also benefit from cochlear implantation. OBJECTIVE To perform a systematic review to identify audiologic thresholds (in dB HL) that could serve as an audiologic candidacy criterion for pediatric cochlear implantation using 4 domains of speech and language development as independent outcome measures (speech production, speech perception, receptive language, and auditory performance).EVIDENCE REVIEW PubMed and Embase databases were searched up to June 28, 2017, to identify studies comparing speech and language development between children who were profoundly deaf using cochlear implants and children with severe hearing loss using hearing aids, because no studies are available directly comparing children with severe HI in both groups. If cochlear implant users with profound HI score better on speech and language tests than those with severe HI who use hearing aids, this outcome could support adjusting cochlear implantation candidacy criteria to lower audiologic thresholds. Literature search, screening, and article selection were performed using a predefined strategy. Article screening was executed independently by 4 authors in 2 pairs; consensus on article inclusion was reached by discussion between these 4 authors. This study is reported according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement.FINDINGS Title and abstract screening of 2822 articles resulted in selection of 130 articles for full-text review. Twenty-one studies were selected for critical appraisal, resulting in selection of 10 articles for data extraction. Two studies formulated audiologic thresholds (in dB HLs) at which children could qualify for cochlear implantation: (1) at 4-frequency pure-tone average (PTA) thresholds of 80 dB HL or greater based on speech perception and auditory performance subtests and (2) at PTA thresholds of 88 and 96 dB HL based on a speech perception subtest. In 8 of the 18 outcome measures, children with profound HI using cochlear implants performed similarly to children with severe HI using hearing aids. Better performance of cochlear implant users was shown with a picture-naming test and a speech perception in noise test. Owing to large heterogeneity in study population and selected tests, it was not possible to conduct a meta-analysis. CONCLUSIONS AND RELEVANCEStudies indicate that lower audiologic thresholds (Ն80 dB HL) than are advised in current national and manufacturer guidelines would be appropriate as audiologic candidacy criteria for pediatric cochlear implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy

Kleijn

Kalmthout

Vossen

et al. 2018

JAMA Otolaryngol Head Neck Surg

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“…This device allows children to hear external sounds and their own voice, thus promoting language acquisition that, in certain cases, can reach the typical range. The benefits of CIs are well established in the literature, as shown by numerous studies ( Bittencourt et al., 2012 ; Niparko et al., 2010 ; Peixoto et al., 2013 ). Svirsky et al.…”

Section: Introductionmentioning

confidence: 92%

Children with hearing impairment and early cochlear implant: A pragmatic assessment

Hilviu

Parola

Vivaldo

et al. 2021

Heliyon

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Extensive research has demonstrated the benefits of cochlear implants (CI) in contributing to improve the linguistic skills of children with hearing impairment; however, few studies have focused on the development of pragmatic ability and its relationship with age of implantation. Pragmatics is the ability to use language in different contexts and its development has crucial implications, e.g., social inclusion and professional attainments. In this study, we conducted a comprehensive assessment of pragmatic ability using the Language Pragmatic Abilities (APL Medea), a battery composed by five different tasks: Comprehension of Metaphors, Implicit meaning, Comics, Situations and Colors Game (a perspective taking task). Eighteen children with early CI, belonging to 3 different age groups (6; 11-7; 11, 8; 0-8; 11 and 9; 0-9; 11 years-old), and twenty-four children with typical development (Control Group) participated to the study. We also investigated how the precocity of CI, i.e., age of first implantation, may affect the pragmatic development.Globally, children with CI obtained lower scores in the APL Medea battery than typically hearing children. However, focusing on the Medea tasks separately, children with CIs differed from their hearing peers only in Comics and Colors Game tasks. Finally, age of implantation was a moderate but significant predictor of pragmatic performance.

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“…1). That is, clinicians should refer pediatric patients for evaluation if they meet any of the following criteria: appropriately selected word recognition scores <50% correct (Dettman et al 2004;Bittencourt et al 2012); unaided pure-tone thresholds >70 dB HL (Davidson 2006;Fitzpatrick et al 2009;Leigh et al 2011Leigh et al , 2016Bittencourt et al 2012;Leal et al 2016); or poor functional performance, limited progress in language or auditory development, or poor quality of life (Mondain et al 2002;Lazaridis et al 2010;Vickers et al 2016). In summary, clinicians should consider audiometric criteria, speech perception, and functional outcomes when referring a child for a CI candidacy evaluation.…”

Section: Candidacy Considerationsmentioning

confidence: 99%

American Cochlear Implant Alliance Task Force Guidelines for Determining Cochlear Implant Candidacy in Children

et al. 2022

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This article summarizes the available evidence on pediatric cochlear implantation to provide current guidelines for clinical protocols and candidacy recommendations in the United States. Candidacy determination involves specification of audiologic and medical criteria per guidelines of the Food and Drug Administration. However, recommendations for a cochlear implant evaluation also should maintain flexibility and consider a child’s skill progression (i.e., month-for-month progress in speech, language, and auditory development) and quality of life with appropriately fit hearing aids. Moreover, evidence supports medical and clinical decisions based on other factors, including (a) ear-specific performance, which affords inclusion of children with asymmetric hearing loss and single-sided deafness as implant candidates; (b) ear-specific residual hearing, which influences surgical technique and device selection to optimize hearing; and (c) early intervention to minimize negative long-term effects on communication and quality of life related to delayed identification of implant candidacy, later age at implantation, and/or limited commitment to an audiologic rehabilitation program. These evidence-based guidelines for current clinical protocols in determining pediatric cochlear implant candidacy encourage a team-based approach focused on the whole child and the family system.

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Prelingual deafness: Benefits from cochlear implants versus conventional hearing aids

Cited by 10 publications

References 10 publications

Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy

Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy

Children with hearing impairment and early cochlear implant: A pragmatic assessment

American Cochlear Implant Alliance Task Force Guidelines for Determining Cochlear Implant Candidacy in Children

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