Surgery and functional outcomes in deaf children receiving cochlear implants before age 2 years

Abstract

Objective: To examine the feasibility of cochlear implantation in children younger than 2 years regarding surgery and functional outcomes. Design(s): Prospective study. Setting(s): Tertiary pediatric cochlear implant center. Patient(s): A consecutive sample of 12 children younger than 2 years at the time of cochlear implantation (8 boys and 4 girls). The cause of hearing loss was meningitis in 6 children and congenital in 6. Intervention(s): Multichannel cochlear implantation using the Nucleus C124M (Cochlear Co, Sydney, Australia) device. Functional outcome was assessed using the Listening Progress Profile and the Categories of Auditory Performance. Main Outcome Measure(s): Perioperative and postoperative surgical complications and functional outcome. Result(s): Eight children had a completely patent cochlea. Four children required a 3- to 5-mm drilling to reach the scala tympani because of ossification after meningitis. Full insertion was achieved in 11 patients; the other child received 18 electrodes. One patient had temporary facial nerve. weakness; 2 others had wound edema and serous discharge that resolved with conservative management. In the longer term, 1 child experienced a single episode of acute otitis media; another had recurrent episodes of otitis media. Mean Listening Progress Profile scores increased from 1 to 42 and median Categories of Auditory Performance scores increased from 0 to 5 at 2 years postsurgery. Comparison with the scores in the 2- to 5-year group showed no significant differences. No significant tuning difficulties were experienced with all children. Conclusion(s): Cochlear implantation is feasible in children younger than 2 years without significant surgical complications or particular tuning difficulties. Functional results 2 years after implantation were as good as or better than those of children who underwent implantation between ages 2 and 5 years.