Hypothesis
Image-guided cochlear implant (CI) programming can improve hearing outcomes for pediatric CI recipients.
Background
CIs have been highly successful for children with severe-to-profound hearing loss, offering potential for mainstreamed education and auditory-oral communication. Despite this, a significant number of recipients still experience poor speech understanding, language delay, and, even among the best performers, restoration to normal auditory fidelity is rare. While significant research efforts have been devoted to improving stimulation strategies, few developments have led to significant hearing improvement over the past two decades. Recently introduced techniques for image-guided CI programming (IGCIP) permit creating patient-customized CI programs by making it possible, for the first time, to estimate the position of implanted CI electrodes relative to the nerves they stimulate using CT images. This approach permits identification of electrodes with high levels of stimulation overlap and to deactivate them from a patient’s map. Prior studies have shown that IGCIP can significantly improve hearing outcomes for adults with CIs.
Methods
The IGCIP technique was tested for 21 ears of 18 pediatric CI recipients. Participants had long-term experience with their CI (5 months-13 years) and ranged in age from 5-17 years old. Speech understanding was assessed after approximately 4 weeks of experience with the IGCIP map.
Results
Using a two-tailed Wilcoxon signed-rank test, statistically significant improvement (p<0.05) was observed for word and sentence recognition in quiet and noise as well as pediatric self-reported quality of life (QOL) measures.
Conclusion
Our results indicate that image-guidance significantly improves hearing and QOL outcomes for pediatric CI recipients.