Efficacy of cochlear implants in children with borderline hearing who have already achieved significant language development with hearing aids

PLoS One. 2022 Jun 1;17(6):e0267898. doi: 10.1371/journal.pone.0267898. eCollection 2022.

Abstract

There are still debates about timing and effectiveness of cochlear implants (CI) in pediatric subjects with significant residual hearing who do not belong to traditional indication of CI. In this study, we aimed to investigate the outcomes of CI, specifically on improvement of pronunciation, among hearing-impaired children already with a substantial degree of language skills as evaluated by Categories of Auditory Perception (CAP) scores or sentence score. Our cohort comprised pediatric CI recipients from July 2018 through October 2020. Among them, cases with CAP scores of 5 or 6 preoperatively were defined as "borderline cases". We investigated prevalence and etiologies, and compared speech evaluation data preoperatively and postoperatively at three time points (3, 6 and 9-12 months after implantation). Among 86 pediatric CI recipients, 13 subjects (15.12%) had language development that reached CAP scores of 5 or 6 before implantation. Postoperative speech evaluation data 6 months after implantation revealed significant improvement of pronunciation (Urimal Test of Articulation and Phonation scores: UTAP), Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and word perception scores, but not of CAP and sentence perception scores. Notably, the significant improvement of pronunciation based on UTAP scores outstripped that of other speech parameters and this continued steadily up to one-year postoperatively. The result of the study serves as evidence for what to expect from cochlear implantation in hearing-impaired children who have already achieved a substantial degree of language development in terms of CAP scores or sentence perception scores, preoperatively.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Cochlear Implantation*
  • Cochlear Implants*
  • Hearing
  • Hearing Aids*
  • Humans
  • Infant
  • Language Development
  • Speech Perception*

Grants and funding

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R1A2B2001054 to B.Y.C.) and the research funds of Seoul National University Bundang Hospital (16-2019-006 to B.Y.C) (13-2018-015 to B.Y.C.). There was no additional external funding received for this study. All the funders and sources of support had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.