Long-term results of cochlear implantation in children with congenital single-sided deafness
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OTOLOGY
Long‑term results of cochlear implantation in children with congenital single‑sided deafness Ann‑Kathrin Rauch1 · Susan Arndt1 · Antje Aschendorff1 · Rainer Beck1 · Iva Speck1 · Manuel Christoph Ketterer1 · Till Fabian Jakob1 · Frederike Hassepass1 Received: 9 May 2020 / Accepted: 28 September 2020 © The Author(s) 2020
Abstract Purpose The purpose of this retrospective study was to investigate the outcome and critical age of cochlear implantation in congenital single-sided deafness (SSD). Methods 11 children with congenital SSD were implanted with a cochlear implant (CI). Auditory performance was measured through the results of speech discrimination, subjective assessment by the Categories of auditory performance (CAP) score, the Speech, Spatial and Qualities scale questionnaire (SSQ) and the German version of the IOI-HA [Internationales Inventar zur Evaluation von Hörgeräten (IIEH, version for CI)]. Results Long-term follow-up [median: 3 years and 5 months (3;5 years)] revealed that nine children use their CI (> 8 h/ day) and two became nonusers. In children aged below 3;2 years at surgery, there was a substantial long-term increase in speech discrimination and subjective benefit. Children over 4;4 years of age at CI surgery improved partially in audiological/ subjective measurements. Among children above 5 years, the SSQ score did not improve despite further slight improvement in speech discrimination long-term. Conclusion Our data suggest a critical age for CI surgery below 3 years in children with congenital SSD for successful hearing rehabilitation. It is mandatory to identify children with SSD as early as bilaterally deaf children. Keywords Cochlear implant · Single sided deafness · Hearing rehabilitation · Age of cochlearimplantation · Binaural hearing · Congenital cytomegalovirus infection · Cochlear nervedeficiency
Introduction Indication for cochlear implantation in single-sided deafness (SSD) has been established for adults with a reduction in tinnitus burden, benefit in localisation, speech discrimination in noise and quality of life [1–3]. Congenital SSD children were shown to perform lower compared to normal hearing (NH) peers at school and they more often had concomitant language impairment [4]. In congenital SSD children, however, no clear indication criteria for a critical age at surgery exist. Reimbursement for costs of implantation are accepted from health insurances in some countries, but there is no exact “cut-off” age for implantation. Some existing case studies and case series describe the short-term outcomes; * Ann‑Kathrin Rauch ann‑kathrin.rauch@uniklinik‑freiburg.de 1
Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
but there are very little long-term data [2, 3, 5, 6]. To better advise patients, parents and caregivers, it is necessary, first, to consider both risks of surgery as well as rehabilitation/ motivation efforts and, second, to relate them to realistic expectations and outcomes after cochlear implantat
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