Cochlear Implantation in Prelingually Deafened Adolescents

Abstract

Objectives:To determine the efficacy of cochlear implantation (CI) in prelingually deafened adolescent children and to evaluate predictive variables for successful outcomes.Design: Retrospective medical record review.Participants: Children aged 10 to 17 years with prelingual hearing loss (mean length of deafness, 11.5 years) who received a unilateral CI (mean age at CI, 12.9 years).Intervention: Unilateral CI. Main Outcome Measures: Standard speech perception testing (Consonant-Nucleus-Consonant [CNC]monosyllabic word test and Hearing in Noise [HINT] sentence test) was performed preoperatively, 1 year postoperatively (year 1), and at the last follow-up/end of the study (EOS).Results: There was a highly significant improvement in speech perception scores for both HINT sentence and CNC word testing from the preoperative testing to year For editorial comment see page 93

Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits

“…The fact that the change 3 years postoperatively once again attained statistical significance, even though the observed score remained the same with an even smaller sample size, is presumably due to the higher estimation of the mean, as predicted by the multilevel model. The mean word recognition scores of 44.1% (range 0-88%) and mean sentence recognition scores of 42.4% (range 0-100%) at the 1-year postoperative measurement are comparable to those found in other studies, although it is unclear for some of these studies whether the reported scores were obtained with CI only or in the best-aided condition [Caposecco et al, 2012;Klop et al, 2007;Santarelli et al, 2008;van Dijkhuizen et al, 2011;Yang et al, 2011;Zeitler et al, 2012]. Consistently with the literature, we found extremely large differences between individual word and sentence recognition scores (Fig.…”

“…Study samples are often small, and a wide range of patient factors are considered that are not uniformly defined across studies. Although not conclusive over all studies, significant relations have been found between CI outcome and a patient's own speech intelligibility [van Dijkhuizen et al, 2016], communication mode [Caposecco et al, 2012;Rousset et al, 2016;Yang et al, 2011;Zeitler et al, 2012], and preoperative speech-understanding scores [Caposecco et al, 2012;Kraaijenga et al, 2016;Rousset et al, 2016;van der Marel et al, 2015;Yang et al, 2011]. At the same time, duration of deafness [Caposecco et al, 2012;Kraaijenga et al, 2016;van der Marel et al, 2015;van Dijkhuizen et al, 2016;Yang et al, 2011] and etiology [Kraaijenga et al, 2016;Zeitler et al, 2012] do not seem to be related to CI outcomes in this patient group.…”

“…Van der Marel et al [2015] equally observed a significant correlation with preoperative phoneme scores. On the other hand, van Dijkhuizen et al [2016] (after Bonferroni correction) and Zeitler et al [2012] did not find a significant correlation with preoperative CNC scores. Similarly to the preoperative CNC scores, our study found the preoperative PTA of the implanted ear to be a significant predictor, whereas the significant correlation of the preoperative PTA of the better ear was dropped in the backward multiple regression modeling procedure.…”

“…Postlingual CI users do generally not show further improvement after 1 year or even 6 months of CI use [Lenarz et al, 2012]. However, some studies assessing early-deafened CI users over time found that auditory performance continued to improve beyond 6 months or even 1 year after implantation [Santarelli et al, 2008;Shpak et al, 2009;Zeitler et al, 2012], whereas other studies observed no further increases beyond the 1-year evaluation moment [van Dijkhuizen et al, 2016;Waltzman et al, 2002] or even earlier [Teoh et al, 2004]. This knowledge is important in order to guide patient expectations, and it may also influence how to design postimplantation rehabilitation.…”

Cochlear implantation in late childhood and adolescence: is there such a thing as ‘too late’?

“…Similarly, in a review by Zeitler et al of 67 patients with prelingual deafness, post-operative cochlear implant performance was retrospectively studied [18]. The mean age at cochlear implantation was 12.9 years with an associated mean duration of deafness of 11.5 years, representing 61% of patients with "Although studies have revealed no age of implantation-dependent difference in electrically evoked compound action potential of the auditory nerve and brainstem following cochlear implantation … differences have been reported in higher order function along the auditory pathway.…”