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Jan 2012

Cochlear Implantation in Prelingually Deafened Adolescents

Author Affiliations

Author Affiliations: Denver Ear Associates, Englewood, Colorado (Dr Zeitler); and Department of Otolaryngology–Head and Neck Surgery, New York University Langone Medical Center (Drs Green, Friedmann, Roland, and Waltzman), and Department of Radiology (Dr Babb), New York University School of Medicine, New York, New York. Mr Anwar is a medical student at the New York University School of Medicine.

Arch Pediatr Adolesc Med. 2012;166(1):35-41. doi:10.1001/archpediatrics.2011.574

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 1 (mean change score, 51.10% and 32.23%, respectively; P < .001) and from the preoperative testing to EOS (mean change score, 60.02% and 38.73%, respectively; P < .001), with a significantly greater increase during the first year (P < .001). In addition, there was a highly significant correlation between improvements in performance scores on the CNC word and HINT sentence speech perception tests and both age at CI and length of deafness at the year 1 testing (P ≤.009) but not from the year 1 testing to EOS testing. Adolescents with progressive deafness and those using oral communication before CI performed significantly better than age-matched peers.

Conclusions Adolescents with prelingual deafness undergoing unilateral CI show significant improvement in objective hearing outcome measures. Patients with shorter lengths of deafness and earlier age at CI tend to outperform their peers. In addition, patients with progressive deafness and those using oral communication have significantly better objective outcomes than their peers.