Low surgical complication rates in cochlear implantation for young children less than 1 year of age

Kalejaiye, Adedoyin; Ansari, Ghedak; Ortega, Gezzer; Davidson, Mauricia; Kim, Hung Jeffrey

doi:10.1002/lary.26135

Cited by 22 publications

(21 citation statements)

References 22 publications

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“…10,11 It is this principle—substantiated by superior performance outcomes and the growing evidence for safety in implanting in infancy—that is supporting the growing practice of pediatric implantation within the first 2 years of life. 12,13…”

mentioning

confidence: 99%

Racial and Insurance Inequalities in Access to Early Pediatric Cochlear Implantation

Liu

Rosa-Lugo

Cosby

et al. 2020

Otolaryngol.--head neck surg.

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Objective To evaluate the association between race/ethnicity and insurance status on the access to early cochlear implantation. Study Design Population-based retrospective analysis of pediatric cochlear implantation procedures. Setting State Ambulatory Surgery and Services Databases of Florida from 2005 to 2017. Methods All children aged 18 years or younger in the state of Florida undergoing cochlear implantation were identified. The outcome measures were access to early cochlear implantation (before 1 and 2 years of age). Descriptive and multivariate logistic regression analyses were conducted. Results Among 1511 pediatric cochlear implantation procedures with complete data, 65 (4.3%) procedures were performed by 1 year of age and 348 (23.0%) by 2 years of age. Black children (odds ratio [OR], 0.44; 95% CI, 0.28-0.70), Hispanic children (OR, 0.70; 95% CI, 0.52-0.94), and children with Medicaid (OR, 0.64; 95% CI, 0.48-0.84) were significantly less likely to be implanted before 2 years of age. Even when insured by private insurance, black and Hispanic children were still less likely to be implanted before 2 years of age compared to white children with private insurance. Greater racial and insurance disparities existed in access to cochlear implantation before 1 year of age compared to implantation before 2 years of age. Conclusion Racial/ethnic and insurance disparities in pediatric cochlear implantation can be observed at the population level. To address these racial and insurance inequalities, a multidisciplinary care team is needed and priorities should be given to research endeavors and policy interventions that target these disparities.

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confidence: 99%

Racial and Insurance Inequalities in Access to Early Pediatric Cochlear Implantation

Liu

Rosa-Lugo

Cosby

et al. 2020

Otolaryngol.--head neck surg.

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“…Due to thinner skin flaps in very young infants, there have been concerns about increased risks of soft tissue complications including skin breakdown 37 . However, Kalejaiye et al reported a soft tissue complication rate of 1.33%, which is comparable to other reported rates in the literature 35,39‐41 …”

Section: Safety and Feasibilitymentioning

confidence: 90%

“…The incidence of a 30‐day post‐operative surgical complication using the American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP) pediatric database was 3.6% for infants <12 months compared with 3.2% for infants 12‐18 months ( P = 1.0) 38 . In a similar large retrospective review of 1278 patients from the ACS‐NSQIP database, Kalejaiye et al showed no significant differences in complication rates (2.73% vs 1.48%, P = .96) when comparing CI recipients <12 months (n = 73) to those >12 months 39 . Patients <12 months were noted to have longer mean operative times (191 minutes vs 160 minutes, P = .0015), which may be attributed to smaller skull size and less developed mastoid cavity with more bone marrow.…”

Section: Safety and Feasibilitymentioning

confidence: 95%

Early pediatric Cochlear implantation: An update

Naik

Varadarajan

Malhotra

2021

Laryngoscope Investig Oto

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The criteria and candidacy for pediatric cochlear implantation (CI) has significantly transformed over the past few decades and continues to evolve with technological advancements, and recognition of benefit in more diverse populations. Prolonged auditory deprivation among patients with profound sensorineural hearing loss has been shown to cause widespread degeneration in the central auditory system. Thus, there is increasing evidence advocating for earlier implantation within a critical neuroplastic window. However, there is a lack of consensus on this optimal age of implantation. Historically, there were concerns regarding surgical feasibility and safety, anesthesia risk, and logistical considerations in very young infants <12 months. Recent literature has investigated surgical safety and anesthesia risk as well speech and language outcomes with early implantation, resulting in the long‐awaited reduction in approved age by the FDA (<9 months for certain devices). This article reviews logistical considerations, surgical safety, anesthesia risk, and language developmental outcomes associated with early CI (<12 months).

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“…By examining the list of reasons why the child had not undergone CI, we see that 17% of parents were concerned about the risk of surgery. Given the low incidence of complication in CI surgery (29), proper education of parents by the surgeon may help increase the likelihood of implantation in potential candidates. For 83% of parents, the source of information for CI was from non-surgeon perspectives.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Access to Cochlear Implantation in Deaf and Hard-of-Hearing Children in Southern California

Moshtaghi¹,

Kuan²,

Mahboubi³

et al. 2019

Otology &Amp; Neurotology

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Objective: To determine the epidemiologic relationship of family demographics and educational resources with parental knowledge of and willingness for their children to receive cochlear implantation (CI) for deaf and hard-of-hearing (DHH) children. Methods: A total of 213 parents of DHH children were surveyed at local schools, specialized camps, and clinics in Southern California. Data on parents were solicited, including income, insurance status, education level, hearing status, primary language, and motivations towards CI. Results: Sixty-six surveys were included in the analysis. Three of these patients had already undergone CI, thus of the 63 children without CI, 59% had been presented with the option of CI by a healthcare professional and 27% were willing to have their child undergo CI. Willingness for children to undergo CI was statistically higher in families with an annual income less than $15,000 or more than $75,000 (p ¼ 0.02), and children enrolled in specialized schools for DHH (p ¼ 0.02). The leading reasons for unwillingness to undergo CI were risks of surgery (17%) and discouragement from others (14%). Conclusion: A significant gap exists between the number of CI candidates and families and willingness to undergo CI. The difference could be related to socioeconomic status and the patient's school type. This underscores the importance of parental education through the use of a multidisciplinary team to ensure all hearing rehabilitation options are explained.

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Low surgical complication rates in cochlear implantation for young children less than 1 year of age

Abstract: 4. Laryngoscope, 127:720-724, 2017.

Cited by 22 publications

References 22 publications

Racial and Insurance Inequalities in Access to Early Pediatric Cochlear Implantation

Racial and Insurance Inequalities in Access to Early Pediatric Cochlear Implantation

Early pediatric Cochlear implantation: An update

Factors Influencing Access to Cochlear Implantation in Deaf and Hard-of-Hearing Children in Southern California

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