Cochlear implantation in prelingually deaf children with ossified cochleae

Abstract

Objective: To evaluate the effects that degree of cochlear ossification has on performance of prelingually deafened children who receive cochlear implants.

Study design: A matched-pairs analysis comparing speech perception results obtained 6 and 24 months after implant by children with ossified and nonossified cochleae. Additionally, long-term performance was evaluated in patients with follow-up periods longer than 24 months. Comparisons were also performed within the ossified cochleae group to determine if degree of cochlear ossification and surgical technique affected outcome with the cochlear implant. SETTING Large cochlear implant program in an academic tertiary care medical center.

Patients: Twenty-one pairs of prelingually deaf children with and without cochlear ossification. Meningitis was the etiology of hearing loss in children with ossified cochleae. The control group had nonmeningitic etiology for the hearing loss.

Interventions: Multichannel cochlear implantation and routine postoperative auditory rehabilitation and performance evaluation.

Main outcome measures: Speech perception category ratings based on scores obtained on a battery of closed- and open-set speech recognition tests 6 and 24 months after implant. Longer follow-up period is also reported.

Results: As a group, children with cochlear ossification showed significant improvement in their speech perception abilities 6 and 24 months after implant. Children with cochlear ossification performed at a significantly lower speech perception category than a group of matched controls with nonossified cochleae at both the 6- and 24-month postimplant intervals. With longer implant use, open-set speech recognition was possible in some children with ossification. Within-group analysis of the children with ossified cochleae revealed that degree of ossification and surgical procedure used for implantation did not significantly affect outcome.

Conclusions: Prelingually deafened children with postmeningitic hearing loss and ossified cochleae receive significant benefit from cochlear implants. Their performance is frequently poorer, however, than children with nonossified cochleae.