Trends in Timing and Provision of Pediatric Cochlear Implant Care During COVID-19

Kimberley S Noij; Emily Y Huang; Jonathan Walsh; Francis X Creighton; Deepa Galaiya; Stephen P Bowditch; C Matthew Stewart; Carolyn M Jenks

doi:10.1002/oto2.37

Trends in Timing and Provision of Pediatric Cochlear Implant Care During COVID-19

OTO Open. 2023 Feb 22;7(1):e37. doi: 10.1002/oto2.37. eCollection 2023 Jan-Mar.

Authors

Kimberley S Noij¹, Emily Y Huang¹, Jonathan Walsh¹, Francis X Creighton¹, Deepa Galaiya¹, Stephen P Bowditch¹, C Matthew Stewart¹, Carolyn M Jenks¹

Affiliation

¹ Department of Otolaryngology-Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA.

Abstract

Objectives: To identify trends in timing of pediatric cochlear implant (CI) care during COVID-19.

Study design: Retrospective cohort.

Setting: Tertiary care center.

Methods: Patients under 18 years of age who underwent CI between 1/1/2016 and 2/29/2020 were included in the pre-COVID-19 group, and patients implanted between 3/1/2020 and 12/31/2021 comprised the COVID-19 group. Revision and sequential surgeries were excluded. Time intervals between care milestones including severe-to-profound hearing loss diagnosis, initial CI candidacy evaluation, and surgery were compared among groups, as were the number and type of postoperative visits.

Results: A total of 98 patients met criteria; 70 were implanted pre-COVID-19 and 28 during COVID-19. A significant increase in the interval between CI candidacy evaluation and surgery was seen among patients with prelingual deafness during COVID-19 compared with pre-COVID-19 (µ = 47.3 weeks, 95% confidence interval [CI]: 34.8-59.9 vs µ = 20.5 weeks, 95% CI: 13.1-27.9; p < .001). Patients in the COVID-19 group attended fewer in-person rehabilitation visits in the 12 months after surgery (µ = 14.9 visits, 95% CI: 9.7-20.1 vs µ = 20.9, 95% CI: 18.1-23.7; p = .04). Average age at implantation in the COVID-19 group was 5.7 years (95% CI: 4.0-7.5) versus 3.7 years in the pre-COVID-19 group (95% CI: 2.9-4.6; p = .05). The time interval between hearing loss confirmation and CI surgery was on average 99.7 weeks for patients implanted during COVID-19 (95% CI: 48.8-150) versus 54.2 weeks for patients implanted pre-COVID (95% CI: 39.6-68.8), which was not a statistically significant difference (p = .1).

Conclusion: During the COVID-19 pandemic patients with prelingual deafness experienced delays in care relative to patients implanted before the pandemic.

Keywords: COVID‐19; pediatric cochlear implantation; rehabilitation.