Paediatric cochlear implantation: prosthetic hearing and language development

JT Rubinstein - The Lancet, 2002 - thelancet.com
JT Rubinstein
The Lancet, 2002thelancet.com
Context Cochlear implantation offers hearing and vocational benefits to children and adults
who lose their hearing after acquiring speech and language. But such implantations in
prelingually deaf children are controversial, with concerns about diagnosis in very young
children, safety, and durability. Implantation of children under age 2 years is potentially
associated with higher surgical and anaesthesia risks, and with more challenging
preoperative and postoperative management. Starting point Although only a small number …
Context Cochlear implantation offers hearing and vocational benefits to children and adults who lose their hearing after acquiring speech and language. But such implantations in prelingually deaf children are controversial, with concerns about diagnosis in very young children, safety, and durability. Implantation of children under age 2 years is potentially associated with higher surgical and anaesthesia risks, and with more challenging preoperative and postoperative management.
Starting point Although only a small number of children implanted before age 2 have sufficient maturity and implant experience to undergo adult-type speech recognition tests, surgical series show that these children may be implanted safely and that their subsequent speech perception is at least as good as children implanted at an older age. The Nottingham, UK, group recently reported on a consecutive sample of 12 children aged under 2 years at implantation (Arch Otolaryngol Head Neck Surg 2002; 128: 11–14). SS Hehar and colleagues show satisfactory perioperative and postoperative surgical outcomes. 2 years after the implantation, mean scores on the Listening Progress Profile had increased from 1 to 42. Median scores of Categories of Auditory Performance increased from 0 to 5. There were no significant differences compared with a historical control group of deaf children implanted at ages 3–5.
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