Current Practices in Pediatric Cochlear Implantation (original) (raw)
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Otolaryngologic Clinics of North America, 2012
Patient selection is one of the most important determinants of cochlear implant success within the pediatric population. 1 Therefore, comprehensive candidacy evaluation is critical to the patient success. The purpose of the candidacy evaluation is to determine the medical and audiometric suitability of the patient for cochlear implantation. Within the pediatric population, the candidacy evaluation varies slightly by age, but maintains a core of essential components. The pediatric cochlear implantation candidacy evaluation should comprise a battery of testing, including a medical evaluation, imaging evaluation, audiologic evaluation, speech and language evaluation, and patient/family counseling. Table 1 provides a synopsis of the components of the cochlear implantation evaluation.
Ear & Hearing, 2022
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.
Current Trends in Pediatric Cochlear Implant Candidate Selection and Postoperative Follow-Up
American Journal of Audiology, 2014
In this article, the authors describe current pediatric cochlear implant (CI) assessment and postoperative scheduling protocols in the United States. Method: A survey was conducted in 2 phases. Results: Response rates were similar between Phase I (10%) and Phase II (13%). Across phases, nearly all respondents reported assessing speech perception both preoperatively and postoperatively.
New Directions in Pediatric Cochlear Implantation
Cochlear implantation has been an approved surgical intervention for children (2-18 years) with profound deafness for nearly 10 years. The last decade has brought technological advances in cochlear implant designs with concomitant improvements in patient performance and subsequent broadening of cochlear implant candidacy. Although average performance levels clearly establish the efficacy of pediatric cochlear implantation, individual communication abilities vary widely. This, controversy exists regarding the appropriate expansion of evolving technology into new patient populations. In this chapter, we review current implant technology, patient selection criteria and performance results for pediatric cochlear implant recipients and consider the challenges inherent in the broadening of cochlear implant candidacy.
Cochlear Implants in Children--A Review
Acta Oto-Laryngologica, 2002
Over the past two decades, cochlear implantation has become a widely accepted treatment of deafness in children. Over 20,000 children have received cochlear implants worldwide. Hearing, language and social development outcomes have been positive. We review current issues in cochlear implantation, candidacy, evaluation, surgery, habilitation, ethics and outcomes.
International Journal of Audiology, 2009
The aims of this study were to investigate statistically the way a revised version of the children's implant profile (GOSHChIP) is used to inform candidacy decisions and explore its utility in predicting outcomes in the first three years of implant use. A retrospective case series analysis design was employed. Data were collated for 127 children with a mean age of 4.7 years at implantation. Concerns in a number of areas of the child's pre-implant functioning as rated on the GOSHChIP (spoken or manual communication skills, cognitive abilities, family structure and support, and use of hearing aids) were associated with speech perception and intelligibility outcomes following implantation. In terms of non-verbal cognitive abilities, the score on tests of fluid reasoning skills (sequencing), that contributes to the cognitive factor on the GOSH-ChIP, was found to significantly predict speech perception and speech intelligibility post implant. The GOSHChIP is a useful tool in making paediatric cochlear implant candidacy decisions, and in forming a guide for counselling parents about the potential benefit their child may receive from an implant.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2020
To determine whether variables such as Age, Gender, Demographic background of the patient and Preoperative usage of hearing aids affect the outcomes of pediatric cochlear implant surgery when modified; in terms of speech and hearing gain. A hospital based retrospectiveprospective type of cohort study was conducted over a period of 5 years at a Tertiary care Teaching hospital and referral centre covering a population of about 68.9 million. Candidates selected were 1-5 years of age with bilateral congenital severe-profound sensori-neural hearing loss. 50 patients were selected and were operated using VERIA technique of Cochlear Implant Surgery. Intraoperative testing of electrode functioning was done in all patients using NRT technique. The switching on of implant was done after 1 month, following which patients underwent 100 sessions of auditory verbal therapy and training. Outcomes were evaluated in terms of hearing and speech gain by using Revised CAP scores, ITMAIS scores and PEACH scores in the loco-regional language. Those implanted at a younger age and with at least 3 months of hearing aid usage pre-operatively had better outcomes measures. There was no effect on outcomes when the gender and demographic origin of the patient were compared. Candidates implanted before 3 years age give better results and they should be encouraged to use hearing aid regularly and continuously before the surgery and should be advised trial and fitting as soon as CI planning begins. Also, gender and demographic background should not be considered when planning CI as these have no significant effect on outcomes.
Cochlear Implantation in Pediatrics: The Effect of Cochlear Coverage
Journal of Personalized Medicine
The effect of insertion depth and position of cochlear implant (CI) electrode arrays on speech perception remains unclear. This study aimed to determine the relationship between cochlear coverage and speech performance in children with prelingual hearing loss with CI. Pure tone audiometry (PTA) and speech audiometry, including speech reception threshold (SRT) using spondee words and speech discrimination score (SDS) using phonetically balanced monosyllabic words, were tested. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scales were also used. Thirty-one ears were implanted with the FLEX 28 electrode array, and 54 with the FORM 24 were included in the current study. For the studied ear, the mean cochlear duct length was 30.82 ± 2.24 mm; the mean cochlear coverage was 82.78 ± 7.49%. Cochlear coverage was a significant negative predictor for the mean pure tone threshold across frequecnies of 0.5, 1, 2, and 4 kHz (PTA4) (p = 0.019). Cochlear cover...