Cochlear Implantation in Children with Postlingual Progressive Steeply Sloping High-Frequency Hearing Loss

Meredith, Margaret A.; Rubinstein, Jay T.; Sie, Kathleen C.Y.; Norton, Susan J.

doi:10.3766/jaaa.16115

Cited by 17 publications

(12 citation statements)

References 19 publications

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“…Modified trajectory, electrode designs and additional oto-protective measures further improved the hearing preservation (HP) results. The technique offers new possibilities to treat children with language and speech deficiencies that are caused by mid-to high-frequency hearing loss during early development with remaining low tone hearing, that benefit little from hearing aid amplification (Carlson et al, 2017;Kuthubutheen et al, 2012;Meredith et al, 2017;Wilson et al, 2016). Despite initial success, it became apparent that long-term studies are necessary to validate conceivable progressive deterioration of residual hearing.…”

Section: Introductionmentioning

confidence: 99%

Cochlear implantation and residual hearing preservation long-term follow-up of the first consecutively operated patients using the round window approach in Uppsala, Sweden

Schart-Morén

Erixon

et al. 2020

Cochlear Implants International

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Objective: We conducted a long-term follow-up study to investigate the time course of residual hearing in our first 21 consecutively operated cochlear implant (CI) patients using the round window (RW) approach . The study may provide additional information about the influence of a flexible lateral wall electrode array on cochlear function. Methods: Data were available for long-term follow-up (>5 years) in 15 patients. Pure tone audiometry (PTA) was assessed at 0.125-8 kHz preoperatively, and at one, three and >5 years postoperatively. Insertion angle, number of electrodes inside the cochlea, user-time of the processor and stimulation strategy were documented. Results: Twelve out of 15 patients had residual hearing after a follow-up period of five years (mean 86 months, range: 61-103 months). Four out of 15 patients had >75% complete hearing preservation (HP), 8 out of 15 had 25-75% partial HP and 3 out of 15 patients had complete loss of hearing. There was a high correlation between insertion angle and HP. Conclusion: Long-term HP was possible in 12 out of 15 cases. Even patients with complete hearing loss at long-term follow-up showed high performance in speech understanding and were full-time users.

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Section: Introductionmentioning

confidence: 99%

Cochlear implantation and residual hearing preservation long-term follow-up of the first consecutively operated patients using the round window approach in Uppsala, Sweden

Schart-Morén

Erixon

et al. 2020

Cochlear Implants International

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“…Recent research has shown that children with PTA poorer than 60 dB HL have a 75% chance of performing better with a CI than a HA [Leigh et al, 2016]. Despite the proven benefits of cochlear implantation in children with residual hearing and poor word recognition [ (Carlson et al 2015); Gratacap et al, 2015;Meredith et al, 2017], the current FDA guidelines are limited to children with, at best, a severe-to-profound hearing loss. With a significant improvement from pre-to postoperative word recognition, our results support previous work indicating benefits of implantation in nontraditional pediatric CI candidates.…”

Section: Discussionmentioning

confidence: 99%

“…They found an average 26 percentage point increase in open-set word recognition after 1 year of CI use. Meredith et al [2017] found a mean word recognition increase of 57 percentage points 1 month after activation in children with high-frequency hearing loss. Carlson et al [2015] called for changes in pediatric candidacy criteria after finding a mean speech recognition improvement of 63 percentage points following cochlear implantation in children with less than severe hearing loss and speech perception skills exceeding 30%.…”

Section: Introductionmentioning

confidence: 89%

Delaying Cochlear Implantation Impacts Postoperative Speech Perception of Nontraditional Pediatric Candidates

et al. 2020

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Introduction: As pediatric cochlear implant (CI) candidacy expands, children with greater degrees of residual hearing are receiving CIs. These nontraditional candidates have audiometric thresholds that meet adult manufacturer labeling but are better than current pediatric guidelines allow. The purpose of this study was to determine the impact of delayed cochlear implantation on speech perception in nontraditional pediatric CI recipients. Methods: Pediatric CI recipients with a history of progressive hearing loss and a preoperative 4-frequency pure-tone average of ≤75 dB HL at the time of implantation were considered for this retrospective study. Preoperative serial audiograms and word recognition scores were reviewed, and a method was created to establish a date when each individual ear 1st met nontraditional candidacy. The length of time between the date of candidacy and implantation was calculated and defined as the “delay time.” A multiple linear regression investigated delay time, age at surgery, surgery type (1st vs. 2nd side), and array type as predictive factors of maximum postoperative Consonant-Nucleus-Consonant (CNC) word scores. A one-way ANCOVA was performed comparing the postoperative CNC scores between subjects grouped by delay time. Results: A significant regression was found (F(4, 38) = 5.167, p = 0.002, R2 = 0.353). Both age at implantation (p = 0.023) and delay time (p = 0.002) predicted CNC word scores. Longer delay time was associated with poorer word recognition scores, while older age at implantation correlated with higher CNC word scores in this progressive hearing loss group. A significant difference was noted between subjects implanted with <1 year of delay and those with 3 or more years of delay (p = 0.003). All ears implanted within a year of candidacy achieved word recognition abilities that are generally accepted as above average (M = 84.91). Conclusion: CI candidacy for adults has evolved to allow for greater degrees of residual hearing, while audiometric guidelines for children have not changed since 2000. Our findings suggest that delay of cochlear implantation, even for children with significant levels of residual hearing, leads to poorer outcomes. Modified candidacy guidelines for children should be established to expedite referral to multidisciplinary CI teams and minimize delays in this population.

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“…Preservation of low-frequency hearing resulted in excellent pure tone thresholds and speech perception scores, even in children. 7 Moreover, Todt et al . 8 suggested using the round window route for electrode insertion to preserve vestibular function.…”

Section: Introductionmentioning

confidence: 99%

Spectral resolution and speech perception after cochlear implantation using the round window versus cochleostomy technique

et al. 2021

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Objective To evaluate the spectral resolution achieved with a cochlear implant in users who were implanted using round window route electrode insertion versus a traditional cochleostomy technique. Methods Twenty-six patients were classified into two groups according to the surgical approach: one group (n = 13) underwent cochlear implantation via the round window technique and the other group (n = 13) underwent surgery via cochleostomy. Results A statistically significant difference was found in spectral ripple discrimination scores between the round window and cochleostomy groups. The round window group performed almost two times better than the cochleostomy group. Differences between Turkish matrix sentence test scores were not statistically significant. Conclusion The spectral ripple discrimination scores of patients who had undergone round window cochlear implant electrode insertion were superior to those of patients whose cochlear implants were inserted using a classical cochleostomy technique.

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Cochlear Implantation in Children with Postlingual Progressive Steeply Sloping High-Frequency Hearing Loss

Cited by 17 publications

References 19 publications

Cochlear implantation and residual hearing preservation long-term follow-up of the first consecutively operated patients using the round window approach in Uppsala, Sweden

Cochlear implantation and residual hearing preservation long-term follow-up of the first consecutively operated patients using the round window approach in Uppsala, Sweden

Delaying Cochlear Implantation Impacts Postoperative Speech Perception of Nontraditional Pediatric Candidates

Spectral resolution and speech perception after cochlear implantation using the round window versus cochleostomy technique

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