Clinical Trials & Research

Many individuals are apprehensive in using cochlear implants in kids. Researchers from the Ann & Robert H. Lurie Children’s Hospital of Chicago cleared the air on this issue.

Cochlear implants are implantable hearing devices. Patients have to undergo complex surgical procedure requiring anesthesia as well as a long follow-up to help restore hearing loss. Because of this, there is substantial concern about the use of cochlear implants in children.

Speech development takes place in the early years of life. Infants perceive speech by six months of age and develop language by two years. Those who are deaf often fail to develop language and end up being mute. Researchers from Ann & Robert H. Lurie Children’s Hospital of Chicago, USA undertook a study to show the safety and effectiveness of cochlear implants in young children and how they can benefit speech development. This study was published in the journal Otology& Neurotology.

The study included 219 children below three years of age. The youngest child to receive cochlear implants in this study was 5.9 months of age.15.5% of the children had a complex medical history. The researchers studied post-operative surgical or anesthetic complications, their primary mode of communication and ability to understand speech after cochlear implantation, using special tests.

The participants were followed up for 7.5 years on average. Children with higher risks of anesthesia, as per American Society of Anesthesiology (ASA) Physical Status Classification, were also included in the study to demonstrate the safety of cochlear implants in high-risk groups.

Early cochlear implantation demonstrated promising results

Infants who had cochlear implants acquired auditory skills more rapidly and showed early speech understanding ability than those implanted as toddlers. In addition, 88.2% of them exclusively used spoken language to communicate. The age at implantation was especially significant for medically complex children, two-thirds of them achieved an oral-only mode of communication when implanted below the age of one year.

No major, unanticipated surgical and anesthetic complications were noticed in the study. This can be attributed to the experienced anesthetic team and improved anesthetic facilities available at present.

Growing literature states that early cochlear implantation results in rapid auditory development and exclusive oral communication, without the necessity of sign language. This study further substantiates the above fact.

The limitations of this study include the inability to measure the level of speech perception due to young age groups and developmental status of the kids which require more sophisticated tests and procedures. More research on the comprehension ability, receptive and expressive language skills is required. The effects of socioeconomic status and parenting on the study results need to be explored.

Many children are not evaluated for cochlear implants until they are more than one year old

At present, screening tests for hearing loss are routinely used, leading to early detection of hearing loss and use of hearing aids. However, increased awareness and prompt referral, with the promotion of cochlear implants are essential.

In the words of Stephen Hoff, Associate Professor at Northwestern University Feinberg School of Medicine in a recent press release, “More than 90% of deaf children have hearing parents. Most parents hope that a cochlear implant will enable their child to talk. However, early implantation is not a public policy priority. For this reason, many children are not evaluated for cochlear implantation until they are over age 12 months.”

Cochlear implants can give a new lease of life in children with hearing loss. Early language development with their use can contribute to a better quality of life in children with hearing loss.

Written by Dr. Radhika Baitari, MS

References:

  1. Hoff S, Ryan M, Thomas D, Tournis E, Kenny H, Hajduk J et al. Safety and Effectiveness of Cochlear Implantation of Young Children, Including Those With Complicating Conditions. Otology & Neurotology. 2019;40(4):454-463.
  2. Kids with cochlear implants since infancy more likely to speak, not sign [Internet]. EurekAlert!. 2019 [cited 4 April 2019]. Available from: https://www.eurekalert.org/pub_releases/2019-03/arh-kwc030519.php

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