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Review
. 2021 May 12;6(3):512-521.
doi: 10.1002/lio2.574. eCollection 2021 Jun.

Early pediatric Cochlear implantation: An update

Akash N Naik  1 , Varun V Varadarajan  1 , Prashant S Malhotra  2
Affiliations
Review

Early pediatric Cochlear implantation: An update

Akash N Naik et al. Laryngoscope Investig Otolaryngol. .

Abstract

The criteria and candidacy for pediatric cochlear implantation (CI) has significantly transformed over the past few decades and continues to evolve with technological advancements, and recognition of benefit in more diverse populations. Prolonged auditory deprivation among patients with profound sensorineural hearing loss has been shown to cause widespread degeneration in the central auditory system. Thus, there is increasing evidence advocating for earlier implantation within a critical neuroplastic window. However, there is a lack of consensus on this optimal age of implantation. Historically, there were concerns regarding surgical feasibility and safety, anesthesia risk, and logistical considerations in very young infants <12 months. Recent literature has investigated surgical safety and anesthesia risk as well speech and language outcomes with early implantation, resulting in the long-awaited reduction in approved age by the FDA (<9 months for certain devices). This article reviews logistical considerations, surgical safety, anesthesia risk, and language developmental outcomes associated with early CI (<12 months).

Keywords: anesthesia risk; infant; language and speech development; pediatric cochlear implantation; surgical safety.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Postauricular incision marked out. Marked level of bony external auditory canal is approximately 1/3 superior from the palpated mastoid tip
FIGURE 2
FIGURE 2
Offset periosteal and skin incisions. View is angled superiorly
FIGURE 3
FIGURE 3
A, Non‐pneumatized marrow space in lateral mastoid and Koerner's septum. B, Koerner's septum opened and lateral semicircular canal and antrum level visible. C, Koerner's septum opened, revealing border of pneumatized air cell space with lateral marrow bone. Round window visible in facial recess. Note the relatively high mastoid tip
FIGURE 4
FIGURE 4
Cochlear implant electrode array after round window insertion
FIGURE 5
FIGURE 5
Coiled array in small mastoid, held in place with absorbable gelatin sponge
See this image and copyright information in PMC

References

    1. Fretz RJ, Fravel RP. Design and function: a physical and electrical description of the 3m house cochlear implant system. Ear Hear. 1985;6(3):14S‐19S. 10.1097/00003446-198505001-00004. - DOI - PubMed
    1. Moore DR. Postnatal development of the mammalian central auditory system and the neural consequences of auditory deprivation. Acta Otolaryngol. 1985;99(S421):19‐30. 10.3109/00016488509121753. - DOI - PubMed
    1. Nikolopoulos TP, O'Donoghue GM, Archbold S. Age at implantation: its importance in pediatric cochlear implantation. Laryngoscope. 1999;109(4):595‐599. 10.1097/00005537-199904000-00014. - DOI - PubMed
    1. Knudsen EI. Sensitive periods in the development of the brain and behavior. J Cogn Neurosci. 2004;16(8):1412‐1425. 10.1162/0898929042304796. - DOI - PubMed
    1. Kral A. Auditory critical periods: a review from system's perspective. Neuroscience. 2013;247:117‐133. 10.1016/j.neuroscience.2013.05.021. - DOI - PubMed

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