Results of Pediatric Cochlear Implantation Compared with Results Obtained with Hearing Aids

Abstract

Objectives: The performance of cochlear implanted children was evaluated in comparison with results of children wearing hearing aids. Patients and Methods: 88 cochlear implanted children were included in this study. Onset of deafness was prelingual (except 1 perilingual), mean age at implantation was 5.4 years (range 1–17.2), preoperative pure tone average (PTA) ranged from 130 to 83 dB HL in the better ear with a mean value of 110.5 dB HL. The hearing aid group consisted of 34 children with prelingual onset of hearing loss. PTA ranged from 122 to 46 dB HL, mean age at test was 5.3 years (range 1.3–15.4). The ‘Frankfurt Functional Hearing Test’ was used for evaluation. Based on the results of the hearing aid group, predicted performance with hearing aids was calculated individually for all cochlear implanted children and compared to the actual results with cochlear implants. Results and Conclusions: Results of cochlear implanted children improved steadily after implantation, progressing from a compound score of 22% prior to implantation to 72.2% after 4–9 years. Actual performance with cochlear implants was significantly better than predicted values with hearing aids. Children implanted prior to age 6 showed a greater benefit and faster improvements after implantation than children implanted later. The performance of children implanted beween age 2 and 4 was equivalent to the mean performance of children with hearing loss of 70–85 dB wearing hearing aids.

Scala vestibuli Insertion in Cochlear Implantation: A Valuable Alternative for Cases with Obstructed Scala tympani

“…Using a scala vestibuli approach the electrode (MED-EL ® Combi-40+) could be inserted 30 mm. Postoperative development was within the normal range with a compound score of 14% 6 months after first fitting [19].…”

“…Her performance is comparable to a group of 22 children implanted at a mean age of 5 years, who were evaluated with the same test material. They obtained a mean compound score of 33.3%, 6 months after initial fitting [19].…”

Communication Abilities of Children With Aided Residual Hearing

“…[12][13][14] Investigators from different CI centers also have begun to explore performance outcomes in children with aided residual hearing in the moderately severe-to-severe range of hearing loss as an indirect means of evaluating CI efficacy. [15][16][17][18] Results generally have indicated that the highest performing implant users are attaining scores equivalent to children with losses ranging from 70 to 80 dB HL. On the basis of these findings, a more in-depth investigation has been initiated at our 2 centers to compare the speech recognition and language abilities of children with moderately severe-to-severe hearing loss who use conventional amplification to those of a large cohort of children with profound hearing loss who are followed up longitudinally as part of an ongoing investigation of CI outcomes.…”

Delayed Maturation and Sensitive Periods in the Auditory Cortex

“…In congenitally deaf children, cochlear implants enable language development, but the outcome is critically dependent on the age of implantation [Busby et al, 1992[Busby et al, , 1993Manrique et al, 1995;Zwolan et al, 1996;Busby and Clark, 1999;Kiefer et al, 1999]. Congenitally deaf subjects implanted in adulthood showed a markedly poorer performance in speech discrimination than subjects implanted in childhood.…”