Paediatric cochlear implantation: Adverse prognostic factors and trends from a review of 174 cases

Abstract

Objectives

Identification and evaluation of prognostic factors that are associated with paediatric cochlear implantation (PCI) outcomes was the aim of this study.

Methods

A retrospective review of 174 charts was performed at the Royal Children's Hospital and the Hear and Say Centre, Brisbane. This examined the possible influence of a number of variables (including age at implant, family, additional disabilities, surgical complications, gender, GJB2 mutations, meningitis, inner ear malformations, and prematurity) on outcome measures: receptive, expressive, and total language, receptive and expressive vocabulary, speech articulation and categories of auditory performance at 18–24 months post-implant. Multiple regression analysis was used to identify variables related to language and vocabulary outcomes.

Results

The findings suggest that inner ear malformations and family concern are negatively associated with receptive and expressive language and receptive vocabulary scores. There was marginal evidence to suggest that increasing age at implantation was associated with lower receptive and expressive language scores.

Discussion

Prognostic factors that have been adequately validated statistically include inner ear malformations, the influence of family and late age at implantation. However, this study identified a need to define better the impact of the various degrees of inner ear malformations, to particularly emphasize the role of family as a strong predictor of PCI outcomes, and to confine the study of ‘age at implantation’ to pre-lingually deafened children.

Conclusion

Evaluation of prognostic factors is a key element in PCI. This study confirmed several factors that are strongly associated with outcomes. For better research, there is a need for universal standardized outcome measures and development of a standardized framework for recording patient data.

Keywords:

• Paediatric cochlear implantation
• Prognostic factors
• Hearing loss

Acknowledgements

The authors would like to thank Lia Lassig, Clinical Specialist Audiologist, Cochlear Implant Program, Royal Children's Hospital and Dr Gabriella Constantinescu, Jane McGovern, and the Greer McDonald Hear and Say Centre for Deaf Children for their support during this research project.