Assessment of Improvement in Speech Perception and Language Development in Cochlear Implant Surgery : An Interesting Study From a Tertiary Care Hospital of Central India

Abstract

Severe to profound prelingual deafness that is either congenital or acquired is estimated to occur in 0.5 to 3 per 1000 live births. This is often associated with early delays in language development, speech perception, socialization and results in lower academic achievement. These developmental and behavioral problems are severe as 90 % of children are born to normal patients whereas with deaf parents it is less as they have a mutual communication. After much research in this field the first 22 channel cochlear implant surgery was done in 1982. The number of prelingually deafened adults seeking cochlear implant is increasing as these individuals can derive substantial benefit, although their performance is poorer than adults with post-lingual deafness. MATERIAL AND METHODS: The present prospective study was conducted in the Department of ENT, Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur (C.G.) The subject selected were prelingually deafened individuals who were undergoing post cochlear implant speech therapy in the Department. This study included individuals, who underwent cochlear implant surgery in this Department during the period of July, 2008 to September, 2010 and the age was within 10 years at the time of surgery. The study was designed as a prospective longitudinal analysis to asses functioning of patients, who underwent cochlear implantation. A total 37 cochlear implant surgeries were carried out in Department. Of these 3 cases were outside the age criteria of the present study and another 2 cases were lost in follow up. Pre-operatively, detailed information of subject including the age, sex and address as well as contact number was collected. Then a General Examination was followed with reference to Built, Nutrition, Pulse, and Blood pressure, Oedema, Cyanosis, Clubbing and Citrus. A systemic examination was also performed. A Local Examination with special emphasis to tympanic membrane and any middle ear pathology was carried out. All the children were investigated for routine blood, urine tests and a chest x-ray. Audiological and Radiological Evaluation was done. Speech perception and language development was also assessed by using standardized tests. Language quotient (Language age/chronological age) was calculated. RESULT: A total 327 children of 1 to 10 years of age with prelingual deafness came in ENT OPD. Number of male child (169) was slightly more than the female child (158). The ratio of male and female children included in the present study was 1:1. There was statistically significant increase in Ling 6 sound score from preoperative (Mean=15. Children with delayed development are performed out by their normal peers. Yet, these children with a delay in development also show improvement in speech perception after cochlear implantation. Use of early conventional amplification leads to a better speech perception outcome and this, most likely, is also true for language development.