TY - JOUR
T1 - Safety and Effectiveness of Cochlear Implantation of Young Children, Including Those With Complicating Conditions
AU - Hoff, Stephen
AU - Ryan, Maura E
AU - Thomas, Denise
AU - Tournis, Elizabeth
AU - Kenny, Hannah
AU - Hajduk, John
AU - Young, Nancy M
PY - 2019/4/1
Y1 - 2019/4/1
N2 - OBJECTIVE: Determine safety and effectiveness of cochlear implantation of children under age 37 months, including below age 12 months. STUDY DESIGN: Retrospective review. SETTING: Tertiary care children's medical center. PATIENTS: 219 children implanted before age 37 mos; 39 implanted below age 12 mos and 180 ages 12-36 mos. Mean age CI = 20.9 mos overall; 9.4 mos (5.9-11.8) and 23.4 mos (12.1-36.8) for the two age groups, respectively. All but two ≤12 mos (94.9%) received bilateral implants as did 70.5% of older group. Mean follow-up = 5.8 yrs; age last follow-up = 7.5 yrs, with no difference between groups. INTERVENTIONS: Cochlear implantation. MAIN OUTCOME MEASURES: Surgical and anesthesia complications, measurable open-set speech discrimination, primary communication mode(s). RESULTS: Few surgical complications occurred, with no difference by age group. No major anesthetic morbidity occurred, with no critical events requiring intervention in the younger group while 4 older children experienced desaturations or bradycardia/hypotension. Children implanted under 12 mos developed open-set earlier (3.3 yrs vs 4.3 yrs, p ≤ 0.001) and were more likely to develop oral-only communication (88.2% vs 48.8%, p ≤ 0.001). A significant decline in rate of oral-only communication was present if implanted over 24 months, especially when comparing children with and without additional conditions associated with language delay (8.3% and 35%, respectively). CONCLUSIONS: Implantation of children under 37 months of age can be done safely, including those below age 12 mos. Implantation below 12 mos is positively associated with earlier open-set ability and oral-only communication. Children implanted after age 24 months were much less likely to use oral communication exclusively, especially those with complex medical history or additional conditions associated with language delay.
AB - OBJECTIVE: Determine safety and effectiveness of cochlear implantation of children under age 37 months, including below age 12 months. STUDY DESIGN: Retrospective review. SETTING: Tertiary care children's medical center. PATIENTS: 219 children implanted before age 37 mos; 39 implanted below age 12 mos and 180 ages 12-36 mos. Mean age CI = 20.9 mos overall; 9.4 mos (5.9-11.8) and 23.4 mos (12.1-36.8) for the two age groups, respectively. All but two ≤12 mos (94.9%) received bilateral implants as did 70.5% of older group. Mean follow-up = 5.8 yrs; age last follow-up = 7.5 yrs, with no difference between groups. INTERVENTIONS: Cochlear implantation. MAIN OUTCOME MEASURES: Surgical and anesthesia complications, measurable open-set speech discrimination, primary communication mode(s). RESULTS: Few surgical complications occurred, with no difference by age group. No major anesthetic morbidity occurred, with no critical events requiring intervention in the younger group while 4 older children experienced desaturations or bradycardia/hypotension. Children implanted under 12 mos developed open-set earlier (3.3 yrs vs 4.3 yrs, p ≤ 0.001) and were more likely to develop oral-only communication (88.2% vs 48.8%, p ≤ 0.001). A significant decline in rate of oral-only communication was present if implanted over 24 months, especially when comparing children with and without additional conditions associated with language delay (8.3% and 35%, respectively). CONCLUSIONS: Implantation of children under 37 months of age can be done safely, including those below age 12 mos. Implantation below 12 mos is positively associated with earlier open-set ability and oral-only communication. Children implanted after age 24 months were much less likely to use oral communication exclusively, especially those with complex medical history or additional conditions associated with language delay.
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U2 - 10.1097/MAO.0000000000002156
DO - 10.1097/MAO.0000000000002156
M3 - Article
C2 - 30870355
SN - 1531-7129
VL - 40
SP - 454
EP - 463
JO - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
IS - 4
ER -