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. 2023 Dec 14:4:1275808.
doi: 10.3389/fresc.2023.1275808. eCollection 2023.

Children then, adults now: long-term outcomes-performance at 15, 20, and 25 years of cochlear implant use

João Elói Moura  1 , Jorge Humberto Martins  2 , Marisa Alves  1 , Graça Oliveira  1 , Daniela Ramos  1 , Helena Alves  1 , Ricardo Caiado  1 , António Teixeira  3 , Luís Filipe Silva  1 , Jorge Migueis  4
Affiliations

Children then, adults now: long-term outcomes-performance at 15, 20, and 25 years of cochlear implant use

João Elói Moura et al. Front Rehabil Sci. .

Abstract

Motivation: Severe to profound sensorineural hearing loss interferes with a child's development at the cognitive, linguistic, academic, and social levels. Since the beginning of the pediatric auditory rehabilitation program through cochlear implantation in the Ear, Nose, and Throat (ENT) Service of the Coimbra Hospital and University Center (CHUC), Portugal, its mentors defended the early diagnosis of hearing loss followed by timely intervention, and this was considered the starting point to optimize (re)habilitation through this method. Three decades or so later, recently we conducted this study to evaluate the performance of patients implanted in the initial phase of the cochlear implantation program.

Objectives: The study aimed to evaluate the performance of individuals with severe to profound congenital hearing loss who underwent pediatric cochlear implantation and have used the cochlear implant for at least 25 years, to analyze the beneficial effect of early intervention in improving performance results.

Methods: The study sample is composed of 31 individuals with severe to profound congenital hearing loss and no other comorbidities, divided into two groups (Group 1: age at implantation was under 3 years; Group 2: age at implantation was over 3 years). All 31 subjects were evaluated at 15, 20, and 25 years of cochlear implant (CI) use with a comprehensive set of tests. In addition, data were collected regarding the academic level of each participant. The results of both groups were compared to find out if there is an effect of age at implantation on auditory performance, and if there is an improvement in the performance with CI over time (15, 20, and 25 years of use).

Results: The results show that there is a positive effect, with statistical significance, of early implantation on auditory performance, and telephone use. In both groups, there is an increase in performance over time, but it tends to stabilize after 20 years of CI use.

Discussion and conclusion: The results obtained in this work support the importance of early intervention in patients with severe to profound hearing loss who are cochlear implant users and show that CI is an effective and reliable method in the treatment of these patients, contributing to their improved socio-educational integration, and that the benefits last over time.

Keywords: cochlear implants; congenital deafness; long-term outcomes; prelingual hearing loss; speech and language outcomes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Distribution of auditory tests’ results for subjects implanted before and after 3 years of age. Left: the distribution of all obtained test results; right: the estimates of the distributions in the form of a violin plot.
Figure 2
Figure 2
Effect of age of implantation and education (academic level) on percentage of correct answers.
Figure 3
Figure 3
Comparison of the percentage of correct answers obtained for both groups in the three evaluation stages (15, 20, and 25 years after implantation).
Figure 4
Figure 4
Effect of type of speech (live and through the telephone) on the percentage of correct answers. Top: boxplots considering two factors (age of implantation group and type of speech); bottom: boxplots considering an additional third factor (years after implant).
Figure 5
Figure 5
Percentage of correct answers by age of implantation and type of test.
Figure 6
Figure 6
Interaction plot for the several factors with potential influence in the test results. The following are presented, from left to right (and top to bottom): age of implantation (2 groups), time of evaluation years after implantation, type of speech (T for telephonic speech, N otherwise), and type of test.
See this image and copyright information in PMC

References

    1. Chin S, Tsai P, Gao S. Connected speech intelligibility of children with cochlear implants and children with normal hearing. Am J Speech Lang Pathol. (2003) 12(4):440–51. 10.1044/1058-0360(2003/090) - DOI - PubMed
    1. Peixoto C, Spratley J, Oliveira G, Martins JB, Ribeiro C. Effectiveness of cochlear implants in children: long term results. Int J Pediatr Otorhinolaryngol. (2013) 77(4):462–8. 10.1016/j.ijporl.2012.12.005 - DOI - PubMed
    1. Yoshinaga-Itano C, Sedey AL, Wiggin M, Mason CA. Language outcomes improved through early hearing detection and earlier cochlear implantation. Otol Neurotol. (2018) 39(10):1256–63. 10.1097/MAO.0000000000001976 - DOI - PubMed
    1. Canfarotta MW, Dillon MT, Buss E, Pillsbury HC, Brown KD, O’Connell BP. Frequency-to-place mismatch: characterizing variability and the influence on speech perception outcomes in cochlear implant recipients. Ear Hearing. (2020) 41(5):1349–61. 10.1097/AUD.0000000000000864 - DOI - PMC - PubMed
    1. Zheng D, Liu X. Cochlear implantation outcomes in patients with OTOF mutations. Front Neurosci. (2020) 14:1–7. 10.3389/fnins.2020.00447 - DOI - PMC - PubMed

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